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 $616.60 Median $758.58 Typical High $8,511.38 | Facility | None | $616.60 | $758.58 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $891.25 | Professional | None | $616.60 | $707.95 | $891.25 |
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 $645.65 Typical High $977.24 | Professional | None | $524.81 | $645.65 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $954.99 Typical High $1,479.11 | Professional | 50 · Both sides | $794.33 | $954.99 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $407.38 Typical High $616.60 | Professional | 62 · Two surgeons | $331.13 | $407.38 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $1,071.52 | Facility | None | $562.34 | $676.08 | $1,071.52 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,096.48 | Professional | None | $602.56 | $891.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,174.90 Typical High $2,511.89 | Facility | None | $34.67 | $1,174.90 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $4,677.35 | Professional | None | $676.08 | $851.14 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $263.03 | Professional | None | $33.11 | $33.11 | $263.03 |
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 $645.65 Median $724.44 Typical High $1,230.27 | Professional | None | $645.65 | $724.44 | $1,230.27 |
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 $309.03 Median $346.74 Typical High $436.52 | Professional | 52 · Reduced service | $309.03 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $141.25 Typical High $177.83 | Professional | 53 · Discontinued | $123.03 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $660.69 | Professional | 54 · Surgery only | $457.09 | $524.81 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $131.83 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $70.79 Typical High $89.13 | Professional | 56 · Pre-op care only | $61.66 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $489.78 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $426.58 | $489.78 | $616.60 |
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· 46th of 51
$692
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.