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 $549.54 Median $575.44 Typical High $5,248.07 | Facility | None | $549.54 | $575.44 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $660.69 | Professional | None | $549.54 | $588.84 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $724.44 | Professional | None | $467.74 | $549.54 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $954.99 Typical High $2,041.74 | Facility | None | $588.84 | $954.99 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $977.24 | Professional | None | $537.03 | $812.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,047.13 Typical High $1,479.11 | Facility | None | $34.67 | $1,047.13 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $3,019.95 | Professional | None | $537.03 | $691.83 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $1,096.48 | Professional | None | $489.78 | $588.84 | $1,096.48 |
6 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 $275.42 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $478.63 | Professional | 54 · Surgery only | $407.38 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $446.68 |
Where Kentucky sits
The same service costs 7.2 times more in Alaska than in Texas. 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· 48th of 51
$562
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.