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 $851.14 Median $954.99 Typical High $8,511.38 | Facility | None | $851.14 | $954.99 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,023.29 | Professional | None | $851.14 | $912.01 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,230.27 | Professional | None | $758.58 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $575.44 Typical High $891.25 | Professional | 62 · Two surgeons | $478.63 | $575.44 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $3,311.31 | Facility | None | $912.01 | $1,479.11 | $3,311.31 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $1,288.25 Typical High $1,513.56 | Professional | None | $831.76 | $1,288.25 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $2,344.23 | Facility | None | $1,122.02 | $2,137.96 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $5,248.07 | Professional | None | $870.96 | $1,122.02 | $5,248.07 |
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 $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 $776.25 Median $977.24 Typical High $1,737.80 | Professional | None | $776.25 | $977.24 | $1,737.80 |
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 $426.58 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $426.58 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $204.17 | Professional | 53 · Discontinued | $169.82 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $691.83 Typical High $758.58 | Professional | 54 · Surgery only | $645.65 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $151.36 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $645.65 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $602.56 | $645.65 | $707.95 |
Where Kentucky sits
The same service costs 8.3 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· 46th of 51
$955
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.