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 $426.58 Median $524.81 Typical High $3,801.89 | Facility | None | $426.58 | $524.81 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $562.34 | Professional | None | $426.58 | $478.63 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $676.08 | Professional | None | $371.54 | $446.68 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $676.08 Typical High $1,023.29 | Professional | 50 · Both sides | $562.34 | $676.08 | $1,023.29 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $1,412.54 | Facility | None | $446.68 | $741.31 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $758.58 | Professional | None | $501.19 | $616.60 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $977.24 Typical High $1,318.26 | Facility | None | $562.34 | $977.24 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $3,019.95 | Professional | None | $467.74 | $575.44 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $234.42 | Professional | None | $33.11 | $33.11 | $234.42 |
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 $416.87 Median $537.03 Typical High $851.14 | Professional | None | $416.87 | $537.03 | $851.14 |
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 $208.93 Median $239.88 Typical High $281.84 | Professional | 52 · Reduced service | $208.93 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $114.82 | Professional | 53 · Discontinued | $85.11 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $363.08 Typical High $426.58 | Professional | 54 · Surgery only | $316.23 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $72.44 Typical High $85.11 | Professional | 55 · Aftercare only | $63.10 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $47.86 Typical High $56.23 | Professional | 56 · Pre-op care only | $42.66 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $338.84 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $295.12 | $338.84 | $398.11 |
Where Kentucky sits
The same service costs 7.6 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
$490
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.