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 $281.84 Median $851.14 Typical High $2,344.23 | Facility | None | $281.84 | $851.14 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $912.01 Typical High $1,584.89 | Professional | None | $281.84 | $912.01 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $891.25 Typical High $891.25 | Professional | None | $316.23 | $891.25 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $14,454.40 | Facility | None | $1,995.26 | $5,495.41 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $2,398.83 | Professional | None | $295.12 | $512.86 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $776.25 Typical High $3,630.78 | Professional | 50 · Both sides | $446.68 | $776.25 | $3,630.78 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $407.38 Typical High $2,691.53 | Facility | None | $245.47 | $407.38 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $416.87 | Professional | None | $229.09 | $354.81 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,862.09 Typical High $3,311.31 | Facility | None | $436.52 | $1,862.09 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $1,584.89 Typical High $11,481.54 | Professional | None | $295.12 | $1,584.89 | $11,481.54 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $416.87 Median $851.14 Typical High $2,454.71 | Professional | None | $416.87 | $851.14 | $2,454.71 |
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 Facility Modifier 54 · Surgery only Typical Low $208.93 Median $338.84 Typical High $1,737.80 | Facility | 54 · Surgery only | $208.93 | $338.84 | $1,737.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $41.69 Median $67.61 Typical High $346.74 | Facility | 55 · Aftercare only | $41.69 | $67.61 | $346.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $45.71 Typical High $234.42 | Facility | 56 · Pre-op care only | $28.18 | $45.71 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $676.08 Typical High $1,096.48 | Professional | 54 · Surgery only | $208.93 | $676.08 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $134.90 Typical High $218.78 | Professional | 55 · Aftercare only | $41.69 | $134.90 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $91.20 Typical High $144.54 | Professional | 56 · Pre-op care only | $28.18 | $91.20 | $144.54 |
Where Kentucky sits
The same service costs 4.8 times more in Alaska than in Nebraska. 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
$891
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.