How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $794.33 Median $1,071.52 Typical High $2,630.27 | Facility | None | $794.33 | $1,071.52 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,148.15 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,230.27 | Professional | None | $870.96 | $1,023.29 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,513.56 Typical High $1,819.70 | Professional | 50 · Both sides | $1,288.25 | $1,513.56 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,862.09 Typical High $3,311.31 | Facility | None | $1,122.02 | $1,862.09 | $3,311.31 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,621.81 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,344.23 | Facility | None | $1,819.70 | $2,041.74 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $5,754.40 | Professional | None | $1,047.13 | $1,412.54 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $912.01 | Professional | None | $44.67 | $44.67 | $912.01 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,174.90 | $2,187.76 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $575.44 Typical High $630.96 | Professional | 52 · Reduced service | $524.81 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $933.25 | Professional | 54 · Surgery only | $794.33 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $186.21 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $125.89 |
Where Kentucky sits
The same service costs 4.8 times more in Alaska than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kentucky· 49th of 51
$1,096
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.