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 $660.69 Typical High $851.14 | Professional | None | $575.44 | $660.69 | $851.14 |
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 $537.03 Median $676.08 Typical High $1,000.00 | Professional | None | $537.03 | $676.08 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,000.00 Typical High $1,479.11 | Professional | 50 · Both sides | $812.83 | $1,000.00 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $630.96 Typical High $1,000.00 | Facility | None | $537.03 | $630.96 | $1,000.00 |
CareSource Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,023.29 | Professional | None | $616.60 | $851.14 | $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 $831.76 Typical High $4,466.84 | Professional | None | $630.96 | $831.76 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $380.19 | Professional | None | $33.11 | $33.11 | $380.19 |
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 $630.96 Median $776.25 Typical High $1,174.90 | Professional | None | $630.96 | $776.25 | $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 $288.40 Median $331.13 Typical High $416.87 | Professional | 52 · Reduced service | $288.40 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $131.83 Typical High $165.96 | Professional | 53 · Discontinued | $114.82 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $489.78 Typical High $630.96 | Professional | 54 · Surgery only | $426.58 | $489.78 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $125.89 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $66.07 Typical High $83.18 | Professional | 56 · Pre-op care only | $57.54 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $457.09 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $398.11 | $457.09 | $588.84 |
Where Kentucky sits
The same service costs 7.4 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· 44th of 51
$676
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.