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 $588.84 Median $724.44 Typical High $3,801.89 | Facility | None | $588.84 | $724.44 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $851.14 | Professional | None | $588.84 | $676.08 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $954.99 | Professional | None | $524.81 | $660.69 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,000.00 Typical High $1,412.54 | Professional | 50 · Both sides | $776.25 | $1,000.00 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,412.54 | Facility | None | $630.96 | $1,023.29 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,071.52 | Professional | None | $588.84 | $870.96 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,318.26 | Facility | None | $758.58 | $1,071.52 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $4,466.84 | Professional | None | $660.69 | $812.83 | $4,466.84 |
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 $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,202.26 | Professional | None | $616.60 | $794.33 | $1,202.26 |
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 $295.12 Median $338.84 Typical High $426.58 | Professional | 52 · Reduced service | $295.12 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $134.90 Typical High $169.82 | Professional | 53 · Discontinued | $117.49 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $645.65 | Professional | 54 · Surgery only | $446.68 | $501.19 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $100.00 Typical High $128.82 | Professional | 55 · Aftercare only | $89.13 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $67.61 Typical High $85.11 | Professional | 56 · Pre-op care only | $58.88 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $602.56 |
Where Kentucky sits
The same service costs 8.5 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· 42nd 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.