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 $331.13 Typical High $3,801.89 | Facility | None | $239.88 | $331.13 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $331.13 | Professional | None | $263.03 | $263.03 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $275.42 | Professional | None | $165.96 | $199.53 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $398.11 Typical High $2,344.23 | Facility | None | $245.47 | $398.11 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $398.11 | Professional | None | $245.47 | $309.03 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $794.33 Typical High $1,698.24 | Facility | None | $34.67 | $794.33 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $1,380.38 | Professional | None | $223.87 | $263.03 | $1,380.38 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $363.08 | Professional | None | $218.78 | $263.03 | $363.08 |
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 $131.83 Median $131.83 Typical High $165.96 | Professional | 52 · Reduced service | $131.83 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $53.70 Typical High $66.07 | Professional | 53 · Discontinued | $52.48 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $199.53 Typical High $245.47 | Professional | 54 · Surgery only | $194.98 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $39.81 Typical High $50.12 | Professional | 55 · Aftercare only | $38.90 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $186.21 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $181.97 | $186.21 | $229.09 |
Where Kentucky sits
The same service costs 5.2 times more in Alaska than in Texas. 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· 47th of 51
$234
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.