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 $707.95 Median $870.96 Typical High $8,511.38 | Facility | None | $707.95 | $870.96 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,148.15 | Professional | None | $707.95 | $812.83 | $1,148.15 |
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 $575.44 Median $707.95 Typical High $1,148.15 | Professional | None | $575.44 | $707.95 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $1,230.27 Typical High $2,691.53 | Facility | None | $758.58 | $1,230.27 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,258.93 | Professional | None | $758.58 | $1,023.29 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,862.09 Typical High $2,290.87 | Facility | None | $954.99 | $1,862.09 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $6,165.95 | Professional | None | $794.33 | $933.25 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $338.84 | Professional | None | $33.11 | $33.11 | $338.84 |
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 $660.69 Median $794.33 Typical High $1,412.54 | Professional | None | $660.69 | $794.33 | $1,412.54 |
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 $354.81 Median $407.38 Typical High $537.03 | Professional | 52 · Reduced service | $354.81 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $162.18 Typical High $213.80 | Professional | 53 · Discontinued | $141.25 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $812.83 | Professional | 54 · Surgery only | $524.81 | $616.60 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $162.18 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $81.28 Typical High $107.15 | Professional | 56 · Pre-op care only | $70.79 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $758.58 |
Where Kentucky sits
The same service costs 7.2 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
$794
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.