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 $67.61 Median $67.61 Typical High $69.18 | Facility | None | $67.61 | $67.61 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $69.18 Typical High $72.44 | Professional | None | $64.57 | $69.18 | $72.44 |
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 $63.10 Typical High $93.33 | Professional | None | $8.91 | $63.10 | $93.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $13.49 Median $93.33 Typical High $138.04 | Professional | 50 · Both sides | $13.49 | $93.33 | $138.04 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $5.62 Median $39.81 Typical High $57.54 | Professional | 62 · Two surgeons | $5.62 | $39.81 | $57.54 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $67.61 Typical High $107.15 | Facility | None | $56.23 | $67.61 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $109.65 | Professional | None | $66.07 | $93.33 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $109.65 Typical High $1,122.02 | Facility | None | $34.67 | $109.65 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $295.12 | Professional | None | $67.61 | $102.33 | $295.12 |
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 $69.18 Median $91.20 Typical High $128.82 | Professional | None | $69.18 | $91.20 | $128.82 |
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 $32.36 Median $33.88 Typical High $36.31 | Professional | 52 · Reduced service | $32.36 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.80 Typical High $14.79 | Professional | 53 · Discontinued | $13.18 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.23 Typical High $10.96 | Professional | 55 · Aftercare only | $9.77 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.92 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.46 | $6.92 | $7.24 |
Where Kentucky sits
The same service costs 4.5 times more in Wisconsin 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
$64.57
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.