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 $398.11 Median $426.58 Typical High $3,801.89 | Facility | None | $398.11 | $426.58 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $501.19 | Professional | None | $398.11 | $407.38 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $467.74 | Professional | None | $309.03 | $380.19 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $323.59 Typical High $436.52 | Facility | None | $169.82 | $323.59 | $436.52 |
CareSource Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $602.56 | Professional | None | $371.54 | $467.74 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $151.36 Typical High $630.96 | Facility | None | $34.67 | $151.36 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $2,238.72 | Professional | None | $389.05 | $436.52 | $2,238.72 |
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 $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 $363.08 Median $501.19 Typical High $630.96 | Professional | None | $363.08 | $501.19 | $630.96 |
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 $199.53 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $199.53 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $100.00 | Professional | 53 · Discontinued | $79.43 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $380.19 | Professional | 54 · Surgery only | $295.12 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $50.12 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $281.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $275.42 | $281.84 | $354.81 |
Where Kentucky sits
The same service costs 4.2 times more in Wyoming 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· 44th of 51
$389
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.