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 $549.54 Median $676.08 Typical High $8,128.31 | Facility | None | $549.54 | $676.08 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $758.58 | Professional | None | $549.54 | $616.60 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,202.26 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $891.25 | Professional | None | $512.86 | $630.96 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $933.25 Typical High $1,318.26 | Professional | 50 · Both sides | $776.25 | $933.25 | $1,318.26 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $954.99 Typical High $2,691.53 | Facility | None | $575.44 | $954.99 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $954.99 | Professional | None | $575.44 | $776.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,862.09 Typical High $1,995.26 | Facility | None | $707.95 | $1,862.09 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $3,981.07 | Professional | None | $602.56 | $758.58 | $3,981.07 |
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 $741.31 Median $1,479.11 Typical High $5,623.41 | Facility | None | $741.31 | $1,479.11 | $5,623.41 |
United Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,122.02 | Professional | None | $588.84 | $724.44 | $1,122.02 |
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 $269.15 Median $309.03 Typical High $380.19 | Professional | 52 · Reduced service | $269.15 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $123.03 Typical High $151.36 | Professional | 53 · Discontinued | $109.65 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $467.74 Typical High $562.34 | Professional | 54 · Surgery only | $407.38 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $93.33 Typical High $112.20 | Professional | 55 · Aftercare only | $81.28 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $61.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $54.95 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $380.19 | $436.52 | $524.81 |
Where Kentucky sits
The same service costs 7.4 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· 42nd of 51
$676
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.