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 $489.78 Median $645.65 Typical High $8,511.38 | Facility | None | $489.78 | $645.65 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $776.25 | Professional | None | $489.78 | $537.03 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $660.69 | Professional | None | $398.11 | $489.78 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $707.95 Typical High $3,801.89 | Facility | None | $426.58 | $707.95 | $3,801.89 |
CareSource Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $724.44 | Professional | None | $407.38 | $616.60 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $2,818.38 | Facility | None | $691.83 | $2,290.87 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $891.25 Typical High $2,818.38 | Professional | None | $457.09 | $891.25 | $2,818.38 |
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 $512.86 Median $676.08 Typical High $933.25 | Professional | None | $512.86 | $676.08 | $933.25 |
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 $245.47 Median $263.03 Typical High $346.74 | Professional | 52 · Reduced service | $245.47 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $141.25 | Professional | 53 · Discontinued | $97.72 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $524.81 | Professional | 54 · Surgery only | $363.08 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $104.71 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $70.79 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $489.78 |
Where Kentucky sits
The same service costs 5.4 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· 47th of 51
$631
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.