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 $758.58 Median $954.99 Typical High $2,630.27 | Facility | None | $758.58 | $954.99 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,258.93 | Professional | None | $758.58 | $891.25 | $1,258.93 |
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 $660.69 Median $794.33 Typical High $1,318.26 | Professional | None | $660.69 | $794.33 | $1,318.26 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $2,691.53 | Facility | None | $812.83 | $1,318.26 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,380.38 | Professional | None | $812.83 | $1,122.02 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,819.70 Typical High $1,995.26 | Facility | None | $851.14 | $1,819.70 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $6,606.93 | Professional | None | $851.14 | $1,023.29 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $416.87 | Professional | None | $33.11 | $33.11 | $416.87 |
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 $758.58 Median $954.99 Typical High $1,513.56 | Professional | None | $758.58 | $954.99 | $1,513.56 |
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 $380.19 Median $446.68 Typical High $588.84 | Professional | 52 · Reduced service | $380.19 | $446.68 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $177.83 Typical High $234.42 | Professional | 53 · Discontinued | $151.36 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $660.69 Typical High $870.96 | Professional | 54 · Surgery only | $575.44 | $660.69 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $131.83 Typical High $173.78 | Professional | 55 · Aftercare only | $114.82 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $89.13 Typical High $117.49 | Professional | 56 · Pre-op care only | $75.86 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $616.60 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $537.03 | $616.60 | $812.83 |
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· 45th 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.