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 $891.25 Median $1,258.93 Typical High $8,511.38 | Facility | None | $891.25 | $1,258.93 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,258.93 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,584.89 | Professional | None | $812.83 | $1,000.00 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $4,897.79 | Facility | None | $1,023.29 | $1,905.46 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,659.59 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,511.89 Typical High $3,630.78 | Facility | None | $1,479.11 | $2,511.89 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $6,165.95 | Professional | None | $1,202.26 | $1,621.81 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,513.56 | $2,290.87 |
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 $616.60 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $616.60 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $245.47 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $954.99 Typical High $1,096.48 | Professional | 54 · Surgery only | $933.25 | $954.99 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $190.55 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $891.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $870.96 | $891.25 | $1,023.29 |
Where Kentucky sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 47th of 51
$1,230
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.