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 $10.96 Median $10.96 Typical High $11.22 | Facility | None | $10.96 | $10.96 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $11.22 Typical High $12.02 | Professional | None | $10.72 | $11.22 | $12.02 |
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 $10.72 Typical High $15.14 | Professional | None | $8.91 | $10.72 | $15.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $13.18 Median $15.85 Typical High $21.88 | Professional | 50 · Both sides | $13.18 | $15.85 | $21.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $5.62 Median $6.61 Typical High $10.00 | Professional | 62 · Two surgeons | $5.62 | $6.61 | $10.00 |
CareSource Setting Facility Modifier None Typical Low $9.33 Median $10.96 Typical High $17.38 | Facility | None | $9.33 | $10.96 | $17.38 |
CareSource Setting Professional Modifier None Typical Low $10.96 Median $15.14 Typical High $18.20 | Professional | None | $10.96 | $15.14 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $34.67 Typical High $1,122.02 | Facility | None | $18.62 | $34.67 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $18.62 Typical High $257.04 | Professional | None | $11.22 | $18.62 | $257.04 |
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 $11.75 Median $15.49 Typical High $22.39 | Professional | None | $11.75 | $15.49 | $22.39 |
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 $5.25 Median $5.62 Typical High $6.03 | Professional | 52 · Reduced service | $5.25 | $5.62 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.24 Typical High $2.40 | Professional | 53 · Discontinued | $2.14 | $2.24 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.70 Typical High $1.82 | Professional | 55 · Aftercare only | $1.58 | $1.70 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.12 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.07 | $1.12 | $1.20 |
Where Kentucky sits
The same service costs 12.3 times more in Florida 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
$10.72
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.