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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $47.86 | Professional | None | $42.66 | $44.67 | $47.86 |
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 $41.69 Typical High $63.10 | Professional | None | $8.91 | $41.69 | $63.10 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $13.49 Median $61.66 Typical High $93.33 | Professional | 50 · Both sides | $13.49 | $61.66 | $93.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $5.62 Median $24.55 Typical High $38.90 | Professional | 62 · Two surgeons | $5.62 | $24.55 | $38.90 |
CareSource Setting Facility Modifier None Typical Low $37.15 Median $44.67 Typical High $70.79 | Facility | None | $37.15 | $44.67 | $70.79 |
CareSource Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $72.44 | Professional | None | $43.65 | $61.66 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $72.44 Typical High $1,122.02 | Facility | None | $34.67 | $72.44 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $75.86 Typical High $194.98 | Professional | None | $44.67 | $75.86 | $194.98 |
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 $45.71 Median $60.26 Typical High $87.10 | Professional | None | $45.71 | $60.26 | $87.10 |
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 $21.38 Median $22.39 Typical High $23.99 | Professional | 52 · Reduced service | $21.38 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.12 Typical High $9.55 | Professional | 53 · Discontinued | $8.51 | $9.12 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.76 Typical High $7.24 | Professional | 55 · Aftercare only | $6.46 | $6.76 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.47 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.27 | $4.47 | $4.79 |
Where Kentucky sits
The same service costs 4.7 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
$42.66
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.