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 $575.44 Median $707.95 Typical High $8,511.38 | Facility | None | $575.44 | $707.95 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $724.44 | Professional | None | $575.44 | $645.65 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $794.33 | Professional | None | $524.81 | $616.60 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $933.25 Typical High $1,202.26 | Professional | 50 · Both sides | $794.33 | $933.25 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $630.96 Typical High $1,000.00 | Facility | None | $524.81 | $630.96 | $1,000.00 |
CareSource Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,023.29 | Professional | None | $616.60 | $831.76 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,071.52 Typical High $1,949.84 | Facility | None | $34.67 | $1,071.52 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $3,801.89 | Professional | None | $630.96 | $794.33 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $194.98 | Professional | None | $33.11 | $33.11 | $194.98 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,174.90 | Professional | None | $616.60 | $758.58 | $1,174.90 |
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 $281.84 Median $323.59 Typical High $363.08 | Professional | 52 · Reduced service | $281.84 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $128.82 Typical High $147.91 | Professional | 53 · Discontinued | $114.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $489.78 Typical High $549.54 | Professional | 54 · Surgery only | $426.58 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $97.72 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $64.57 Typical High $72.44 | Professional | 56 · Pre-op care only | $57.54 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $457.09 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $398.11 | $457.09 | $512.86 |
Where Kentucky sits
The same service costs 16.6 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
$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.