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 $407.38 Median $501.19 Typical High $5,248.07 | Facility | None | $407.38 | $501.19 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $537.03 | Professional | None | $389.05 | $407.38 | $537.03 |
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 $338.84 Median $416.87 Typical High $562.34 | Professional | None | $338.84 | $416.87 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $2,818.38 | Facility | None | $363.08 | $588.84 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $602.56 | Professional | None | $371.54 | $512.86 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $2,041.74 | Facility | None | $524.81 | $1,659.59 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $2,511.89 | Professional | None | $371.54 | $588.84 | $2,511.89 |
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 $354.81 Median $562.34 Typical High $724.44 | Professional | None | $354.81 | $562.34 | $724.44 |
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 $194.98 Median $204.17 Typical High $263.03 | Professional | 52 · Reduced service | $194.98 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $104.71 | Professional | 53 · Discontinued | $77.62 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $389.05 | Professional | 54 · Surgery only | $295.12 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $77.62 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $52.48 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $275.42 | $288.40 | $363.08 |
Where Kentucky sits
The same service costs 6.2 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· 44th of 51
$468
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.