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 $537.03 Median $676.08 Typical High $5,248.07 | Facility | None | $537.03 | $676.08 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $691.83 | Professional | None | $537.03 | $616.60 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $851.14 | Professional | None | $489.78 | $588.84 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $891.25 Typical High $1,288.25 | Professional | 50 · Both sides | $724.44 | $891.25 | $1,288.25 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $2,691.53 | Facility | None | $575.44 | $933.25 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $933.25 | Professional | None | $588.84 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,659.59 Typical High $1,949.84 | Facility | None | $707.95 | $1,659.59 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $3,630.78 | Professional | None | $602.56 | $741.31 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $371.54 | Professional | None | $33.11 | $33.11 | $371.54 |
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 $562.34 Median $707.95 Typical High $1,096.48 | Professional | None | $562.34 | $707.95 | $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 $269.15 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $123.03 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $407.38 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $81.28 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $380.19 | $436.52 | $478.63 |
Where Kentucky sits
The same service costs 18.6 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· 44th 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.