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 $239.88 Median $302.00 Typical High $3,235.94 | Facility | None | $239.88 | $302.00 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $302.00 | Professional | None | $239.88 | $251.19 | $302.00 |
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 $194.98 Median $245.47 Typical High $363.08 | Professional | None | $194.98 | $245.47 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $363.08 Typical High $2,344.23 | Facility | None | $194.98 | $363.08 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $363.08 | Professional | None | $204.17 | $281.84 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,698.24 Typical High $2,290.87 | Facility | None | $389.05 | $1,698.24 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $1,621.81 | Professional | None | $234.42 | $275.42 | $1,621.81 |
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 $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $389.05 | Professional | None | $218.78 | $302.00 | $389.05 |
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 $120.23 Median $120.23 Typical High $151.36 | Professional | 52 · Reduced service | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $47.86 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $177.83 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.99 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $169.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $165.96 | $169.82 | $213.80 |
Where Kentucky sits
The same service costs 6.0 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· 42nd of 51
$245
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.