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 $1,148.15 Median $1,380.38 Typical High $8,511.38 | Facility | None | $1,148.15 | $1,380.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,412.54 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,778.28 | $4,677.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,584.89 | Professional | None | $912.01 | $1,096.48 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $4,897.79 | Facility | None | $1,071.52 | $1,737.80 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $1,819.70 | Professional | None | $977.24 | $1,479.11 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $3,090.30 Typical High $3,630.78 | Facility | None | $1,862.09 | $3,090.30 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $7,244.36 | Professional | None | $1,122.02 | $1,380.38 | $7,244.36 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,412.54 | $2,041.74 |
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 $575.44 Median $691.83 Typical High $724.44 | Professional | 52 · Reduced service | $575.44 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $275.42 Typical High $288.40 | Professional | 53 · Discontinued | $229.09 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $173.78 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $138.04 Typical High $144.54 | Professional | 56 · Pre-op care only | $114.82 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $1,023.29 |
Where Kentucky sits
The same service costs 5.5 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· 44th of 51
$1,318
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.