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 $562.34 Median $707.95 Typical High $8,511.38 | Facility | None | $562.34 | $707.95 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $831.76 | Professional | None | $562.34 | $645.65 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,332.54 Typical High $11,220.18 | Facility | None | $758.58 | $9,332.54 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $977.24 | Professional | None | $537.03 | $660.69 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $977.24 Typical High $1,479.11 | Professional | 50 · Both sides | $812.83 | $977.24 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $416.87 Typical High $616.60 | Professional | 62 · Two surgeons | $338.84 | $416.87 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $5,888.44 | Facility | None | $602.56 | $977.24 | $5,888.44 |
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 $1,096.48 Typical High $4,466.84 | Facility | None | $34.67 | $1,096.48 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $4,365.16 | Professional | None | $630.96 | $812.83 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $371.54 | Professional | None | $33.11 | $33.11 | $371.54 |
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 $616.60 Median $707.95 Typical High $1,148.15 | Professional | None | $616.60 | $707.95 | $1,148.15 |
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 $416.87 | Professional | 52 · Reduced service | $281.84 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $128.82 Typical High $165.96 | Professional | 53 · Discontinued | $112.20 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $426.58 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $97.72 Typical High $123.03 | Professional | 55 · Aftercare only | $85.11 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $64.57 Typical High $83.18 | Professional | 56 · Pre-op care only | $56.23 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $457.09 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $398.11 | $457.09 | $575.44 |
Where Kentucky sits
The same service costs 8.1 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
$661
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.