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 $575.44 Median $616.60 Typical High $2,630.27 | Facility | None | $575.44 | $616.60 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $758.58 | Professional | None | $602.56 | $616.60 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $588.84 | Professional | None | $416.87 | $478.63 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $2,344.23 | Facility | None | $549.54 | $912.01 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $912.01 | Professional | None | $562.34 | $724.44 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $1,862.09 | Facility | None | $1,071.52 | $1,659.59 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $2,951.21 | Professional | None | $588.84 | $645.65 | $2,951.21 |
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 $537.03 Median $691.83 Typical High $891.25 | Professional | None | $537.03 | $691.83 | $891.25 |
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 $302.00 Median $309.03 Typical High $380.19 | Professional | 52 · Reduced service | $302.00 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $123.03 Typical High $151.36 | Professional | 53 · Discontinued | $120.23 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $457.09 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $114.82 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $426.58 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $416.87 | $426.58 | $537.03 |
Where Kentucky sits
The same service costs 5.6 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· 49th of 51
$513
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.