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 $204.17 Median $263.03 Typical High $851.14 | Facility | None | $204.17 | $263.03 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $281.84 | Professional | None | $204.17 | $223.87 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $9,549.93 | Facility | None | $1,445.44 | $4,265.80 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $263.03 | Professional | None | $169.82 | $208.93 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $2,344.23 | Facility | None | $194.98 | $316.23 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $316.23 | Professional | None | $177.83 | $245.47 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,698.24 Typical High $2,290.87 | Facility | None | $338.84 | $1,698.24 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $1,202.26 | Professional | None | $199.53 | $229.09 | $1,202.26 |
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 $186.21 Median $257.04 Typical High $331.13 | Professional | None | $186.21 | $257.04 | $331.13 |
7 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 $102.33 Median $104.71 Typical High $131.83 | Professional | 52 · Reduced service | $102.33 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $52.48 | Professional | 53 · Discontinued | $41.69 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $158.49 Typical High $194.98 | Professional | 54 · Surgery only | $154.88 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $38.90 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.89 Typical High $26.30 | Professional | 56 · Pre-op care only | $20.42 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $147.91 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $144.54 | $147.91 | $181.97 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | GC · Resident with teaching physician | $114.82 | $114.82 | $114.82 |
Where Kentucky sits
The same service costs 5.6 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
$209
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.