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 $269.15 Median $331.13 Typical High $2,630.27 | Facility | None | $269.15 | $331.13 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $354.81 | Professional | None | $257.04 | $269.15 | $354.81 |
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 $223.87 Median $295.12 Typical High $389.05 | Professional | None | $223.87 | $295.12 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $389.05 Typical High $2,818.38 | Facility | None | $239.88 | $389.05 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $407.38 | Professional | None | $245.47 | $338.84 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,862.09 Typical High $2,089.30 | Facility | None | $416.87 | $1,862.09 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $1,659.59 | Professional | None | $251.19 | $398.11 | $1,659.59 |
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 $251.19 Median $363.08 Typical High $489.78 | Professional | None | $251.19 | $363.08 | $489.78 |
3 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 54 · Surgery only Typical Low $194.98 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $38.90 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $34.67 |
Where Kentucky sits
The same service costs 7.2 times more in Oklahoma than in New York. 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
$295
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.