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 $794.33 Median $1,122.02 Typical High $8,128.31 | Facility | None | $794.33 | $1,122.02 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,174.90 | Professional | None | $891.25 | $1,023.29 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $10,471.29 Typical High $15,135.61 | Facility | None | $3,388.44 | $10,471.29 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,445.44 | Professional | None | $851.14 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,584.89 Typical High $2,187.76 | Professional | 50 · Both sides | $1,258.93 | $1,584.89 | $2,187.76 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $5,888.44 | Facility | None | $954.99 | $1,548.82 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,621.81 | Professional | None | $891.25 | $1,318.26 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,698.24 Typical High $4,466.84 | Facility | None | $34.67 | $1,698.24 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $6,025.60 | Professional | None | $1,000.00 | $1,258.93 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $588.84 | Professional | None | $33.11 | $33.11 | $588.84 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,819.70 | Professional | None | $977.24 | $1,230.27 | $1,819.70 |
4 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 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $870.96 | Professional | 54 · Surgery only | $676.08 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $154.88 Typical High $173.78 | Professional | 55 · Aftercare only | $134.90 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $102.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $89.13 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $812.83 |
Where Kentucky sits
The same service costs 7.6 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
$1,072
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.