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 $794.33 Median $1,096.48 Typical High $2,630.27 | Facility | None | $794.33 | $1,096.48 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,122.02 | Professional | None | $912.01 | $1,047.13 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,174.90 | Professional | None | $676.08 | $851.14 | $1,174.90 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,691.53 | Facility | None | $954.99 | $1,584.89 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,621.81 | Professional | None | $977.24 | $1,318.26 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $2,818.38 | Facility | None | $1,737.80 | $1,862.09 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $5,754.40 | Professional | None | $758.58 | $1,230.27 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $309.03 | Professional | None | $33.11 | $33.11 | $309.03 |
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 $562.34 Median $1,047.13 Typical High $1,862.09 | Professional | None | $562.34 | $1,047.13 | $1,862.09 |
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 $457.09 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $181.97 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $776.25 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $154.88 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $104.71 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $724.44 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $724.44 | $794.33 |
Where Kentucky sits
The same service costs 7.8 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
$871
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.