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 $363.08 Median $457.09 Typical High $5,248.07 | Facility | None | $363.08 | $457.09 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $457.09 | Professional | None | $363.08 | $371.54 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $537.03 | Professional | None | $275.42 | $331.13 | $537.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $173.78 Median $208.93 Typical High $338.84 | Professional | 62 · Two surgeons | $173.78 | $208.93 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $549.54 Typical High $2,344.23 | Facility | None | $331.13 | $549.54 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $575.44 | Professional | None | $316.23 | $416.87 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,584.89 Typical High $1,737.80 | Facility | None | $489.78 | $1,584.89 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $2,630.27 | Professional | None | $354.81 | $398.11 | $2,630.27 |
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 $331.13 Median $426.58 Typical High $549.54 | Professional | None | $331.13 | $426.58 | $549.54 |
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 $181.97 Median $186.21 Typical High $229.09 | Professional | 52 · Reduced service | $181.97 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $91.20 | Professional | 53 · Discontinued | $72.44 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $281.84 Typical High $346.74 | Professional | 54 · Surgery only | $275.42 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $54.95 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $37.15 Typical High $45.71 | Professional | 56 · Pre-op care only | $36.31 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $263.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $257.04 | $263.03 | $323.59 |
Where Kentucky sits
The same service costs 5.1 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· 46th of 51
$363
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.