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 $331.13 Median $416.87 Typical High $2,630.27 | Facility | None | $331.13 | $416.87 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $588.84 | Professional | None | $331.13 | $380.19 | $588.84 |
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 $263.03 Median $316.23 Typical High $831.76 | Professional | None | $263.03 | $316.23 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $478.63 Typical High $1,230.27 | Professional | 50 · Both sides | $389.05 | $478.63 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $588.84 Typical High $5,888.44 | Facility | None | $354.81 | $588.84 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $602.56 | Professional | None | $398.11 | $489.78 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $4,466.84 | Facility | None | $602.56 | $1,862.09 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $3,801.89 | Professional | None | $371.54 | $457.09 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $151.36 | Professional | None | $33.11 | $33.11 | $151.36 |
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 $323.59 Median $436.52 Typical High $676.08 | Professional | None | $323.59 | $436.52 | $676.08 |
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 $165.96 Median $190.55 Typical High $245.47 | Professional | 52 · Reduced service | $165.96 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $97.72 | Professional | 53 · Discontinued | $67.61 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $288.40 Typical High $363.08 | Professional | 54 · Surgery only | $251.19 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $57.54 Typical High $74.13 | Professional | 55 · Aftercare only | $50.12 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $48.98 | Professional | 56 · Pre-op care only | $33.11 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $269.15 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $234.42 | $269.15 | $338.84 |
Where Kentucky sits
The same service costs 7.2 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
$372
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.