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 $1,096.48 Median $4,786.30 Typical High $5,888.44 | Facility | None | $1,096.48 | $4,786.30 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $4,786.30 Typical High $5,888.44 | Professional | None | $2,754.23 | $4,786.30 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $707.95 | Professional | None | $457.09 | $549.54 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $3,467.37 Typical High $5,888.44 | Facility | None | $1,819.70 | $3,467.37 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $5,128.61 Median $6,918.31 Typical High $8,511.38 | Professional | None | $5,128.61 | $6,918.31 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,698.24 Typical High $8,317.64 | Facility | None | $34.67 | $1,698.24 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $3,467.37 Typical High $25,703.96 | Professional | None | $2,884.03 | $3,467.37 | $25,703.96 |
Molina Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,584.89 | $1,659.59 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $3,090.30 Typical High $5,495.41 | Professional | None | $1,862.09 | $3,090.30 | $5,495.41 |
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 $1,380.38 Median $2,398.83 Typical High $2,951.21 | Professional | 52 · Reduced service | $1,380.38 | $2,398.83 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $954.99 Typical High $1,174.90 | Professional | 53 · Discontinued | $549.54 | $954.99 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $707.95 Typical High $891.25 | Professional | 55 · Aftercare only | $416.87 | $707.95 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $478.63 Typical High $588.84 | Professional | 56 · Pre-op care only | $275.42 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $3,311.31 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $1,949.84 | $3,311.31 | $4,073.80 |
Where Kentucky sits
The same service costs 21.4 times more in Alaska than in Kentucky. 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· 51st of 51
$646
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.