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 $1,348.96 Typical High $8,128.31 | Facility | None | $794.33 | $1,348.96 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,230.27 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $10,715.19 Typical High $15,135.61 | Facility | None | $4,786.30 | $10,715.19 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,949.84 Typical High $2,630.27 | Professional | 50 · Both sides | $1,584.89 | $1,949.84 | $2,630.27 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $16,982.44 | Facility | None | $1,148.15 | $1,905.46 | $16,982.44 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,548.82 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,041.74 Typical High $10,232.93 | Facility | None | $34.67 | $2,041.74 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $7,244.36 | Professional | None | $1,202.26 | $1,513.56 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $707.95 | Professional | None | $33.11 | $33.11 | $707.95 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $8,912.51 | Facility | None | $977.24 | $1,862.09 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,479.11 | $2,238.72 |
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 $812.83 Median $933.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $812.83 | $933.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $162.18 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $870.96 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $758.58 | $870.96 | $977.24 |
Where Kentucky sits
The same service costs 8.1 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· 45th of 51
$1,288
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.