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 $630.96 Median $776.25 Typical High $2,630.27 | Facility | None | $630.96 | $776.25 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $776.25 | Professional | None | $478.63 | $676.08 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $912.01 | Professional | None | $524.81 | $630.96 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $398.11 Typical High $630.96 | Professional | 62 · Two surgeons | $331.13 | $398.11 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $2,691.53 | Facility | None | $676.08 | $1,096.48 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,122.02 | Professional | None | $660.69 | $912.01 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,819.70 Typical High $1,995.26 | Facility | None | $660.69 | $1,819.70 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $4,677.35 | Professional | None | $676.08 | $912.01 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $323.59 | Professional | None | $33.11 | $33.11 | $323.59 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,202.26 | Professional | None | $575.44 | $831.76 | $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 $309.03 Median $354.81 Typical High $446.68 | Professional | 52 · Reduced service | $309.03 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $141.25 Typical High $177.83 | Professional | 53 · Discontinued | $125.89 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $524.81 Typical High $660.69 | Professional | 54 · Surgery only | $467.74 | $524.81 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $104.71 Typical High $131.83 | Professional | 55 · Aftercare only | $93.33 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $70.79 Typical High $89.13 | Professional | 56 · Pre-op care only | $63.10 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $616.60 |
Where Kentucky sits
The same service costs 6.6 times more in Alaska than in Utah. 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
$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.