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 $1,737.80 Typical High $2,630.27 | Facility | None | $794.33 | $1,737.80 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,621.81 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,317.64 Median $10,715.19 Typical High $15,135.61 | Facility | None | $8,317.64 | $10,715.19 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,698.24 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,511.89 Typical High $3,548.13 | Professional | 50 · Both sides | $2,041.74 | $2,511.89 | $3,548.13 |
CareSource Setting Facility Modifier None Typical Low $1,479.11 Median $2,454.71 Typical High $5,888.44 | Facility | None | $1,479.11 | $2,454.71 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,548.82 | $2,089.30 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,630.27 Typical High $4,466.84 | Facility | None | $34.67 | $2,630.27 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $9,772.37 | Professional | None | $1,584.89 | $1,995.26 | $9,772.37 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $977.24 | Professional | None | $33.11 | $33.11 | $977.24 |
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 $1,584.89 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,584.89 | $1,949.84 | $2,951.21 |
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 $1,071.52 Median $1,202.26 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $288.40 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $162.18 Typical High $190.55 | Professional | 56 · Pre-op care only | $141.25 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,318.26 |
Where Kentucky sits
The same service costs 7.8 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· 41st of 51
$1,738
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.