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 $281.84 Median $354.81 Typical High $794.33 | Facility | None | $281.84 | $354.81 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $389.05 | Professional | None | $281.84 | $309.03 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,258.93 | $4,073.80 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $416.87 | Professional | None | $234.42 | $295.12 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $380.19 Typical High $4,897.79 | Facility | None | $263.03 | $380.19 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $371.54 | Professional | None | $269.15 | $288.40 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,187.76 Typical High $3,630.78 | Facility | None | $457.09 | $2,187.76 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $1,862.09 | Professional | None | $275.42 | $331.13 | $1,862.09 |
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 $707.95 Median $1,230.27 Typical High $3,890.45 | Facility | None | $707.95 | $1,230.27 | $3,890.45 |
United Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $467.74 | Professional | None | $257.04 | $363.08 | $467.74 |
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 $141.25 Median $144.54 Typical High $177.83 | Professional | 52 · Reduced service | $141.25 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $57.54 Typical High $72.44 | Professional | 53 · Discontinued | $56.23 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $218.78 Typical High $269.15 | Professional | 54 · Surgery only | $213.80 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $43.65 Typical High $53.70 | Professional | 55 · Aftercare only | $42.66 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $35.48 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $204.17 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $199.53 | $204.17 | $251.19 |
Where Kentucky sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 43rd of 51
$295
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.