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 $1,148.15 Typical High $1,202.26 | Facility | None | $891.25 | $1,148.15 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,412.54 | Professional | None | $891.25 | $977.24 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,445.44 | Professional | None | $741.31 | $954.99 | $1,445.44 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $831.76 Typical High $1,318.26 | Facility | None | $691.83 | $831.76 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,348.96 | Professional | None | $891.25 | $1,148.15 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,548.82 | Facility | None | $34.67 | $512.86 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,659.59 Typical High $6,025.60 | Professional | None | $831.76 | $1,659.59 | $6,025.60 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,778.28 | Professional | None | $977.24 | $1,318.26 | $1,778.28 |
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 $446.68 Median $489.78 Typical High $645.65 | Professional | 52 · Reduced service | $446.68 | $489.78 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $194.98 Typical High $257.04 | Professional | 53 · Discontinued | $177.83 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $954.99 | Professional | 54 · Surgery only | $676.08 | $741.31 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $194.98 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $128.82 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $891.25 |
Where Kentucky sits
The same service costs 4.7 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· 40th 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.