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 $74.13 Median $74.13 Typical High $75.86 | Facility | None | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $81.28 | Professional | None | $70.79 | $75.86 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $3,801.89 Typical High $11,220.18 | Facility | None | $575.44 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.91 Median $69.18 Typical High $104.71 | Professional | None | $8.91 | $69.18 | $104.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $13.49 Median $95.50 Typical High $154.88 | Professional | 50 · Both sides | $13.49 | $95.50 | $154.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $6.61 Median $43.65 Typical High $66.07 | Professional | 62 · Two surgeons | $6.61 | $43.65 | $66.07 |
CareSource Setting Facility Modifier None Typical Low $61.66 Median $74.13 Typical High $117.49 | Facility | None | $61.66 | $74.13 | $117.49 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $120.23 | Professional | None | $66.07 | $97.72 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $120.23 Typical High $1,122.02 | Facility | None | $34.67 | $120.23 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $323.59 | Professional | None | $74.13 | $112.20 | $323.59 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $144.54 | Professional | None | $75.86 | $100.00 | $144.54 |
4 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 $35.48 Median $38.02 Typical High $39.81 | Professional | 52 · Reduced service | $35.48 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.14 Typical High $16.22 | Professional | 53 · Discontinued | $14.45 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $12.02 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.59 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.08 | $7.59 | $7.94 |
Where Kentucky sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 51st of 51
$70.79
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.