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 $588.84 Median $776.25 Typical High $2,630.27 | Facility | None | $588.84 | $776.25 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $933.25 | Professional | None | $588.84 | $741.31 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $977.24 | Professional | None | $489.78 | $676.08 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,023.29 Typical High $1,479.11 | Professional | 50 · Both sides | $741.31 | $1,023.29 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $426.58 Typical High $616.60 | Professional | 62 · Two surgeons | $309.03 | $426.58 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $2,691.53 | Facility | None | $501.19 | $851.14 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $891.25 | Professional | None | $524.81 | $741.31 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,819.70 Typical High $1,949.84 | Facility | None | $954.99 | $1,819.70 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $1,202.26 Typical High $3,981.07 | Professional | None | $549.54 | $1,202.26 | $3,981.07 |
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 $691.83 Median $933.25 Typical High $1,202.26 | Professional | None | $691.83 | $933.25 | $1,202.26 |
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 $295.12 Median $323.59 Typical High $416.87 | Professional | 52 · Reduced service | $295.12 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $165.96 | Professional | 53 · Discontinued | $117.49 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $630.96 | Professional | 54 · Surgery only | $436.52 | $489.78 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $125.89 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $83.18 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $588.84 |
Where Kentucky sits
The same service costs 5.9 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· 43rd of 51
$832
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.