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 $794.33 Median $1,047.13 Typical High $2,630.27 | Facility | None | $794.33 | $1,047.13 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,148.15 | Professional | None | $831.76 | $870.96 | $1,148.15 |
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 $707.95 Median $891.25 Typical High $1,288.25 | Professional | None | $707.95 | $891.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $562.34 Typical High $794.33 | Professional | 62 · Two surgeons | $446.68 | $562.34 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $1,258.93 Typical High $4,265.80 | Facility | None | $758.58 | $1,258.93 | $4,265.80 |
CareSource Setting Professional Modifier None Typical Low $707.95 Median $1,096.48 Typical High $1,288.25 | Professional | None | $707.95 | $1,096.48 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $3,311.31 | Facility | None | $1,348.96 | $1,862.09 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $5,370.32 | Professional | None | $794.33 | $1,230.27 | $5,370.32 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,513.56 | Professional | None | $758.58 | $1,071.52 | $1,513.56 |
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 $416.87 Median $436.52 Typical High $549.54 | Professional | 52 · Reduced service | $416.87 | $436.52 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $173.78 Typical High $218.78 | Professional | 53 · Discontinued | $165.96 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $831.76 | Professional | 54 · Surgery only | $616.60 | $645.65 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $165.96 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $109.65 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $776.25 |
Where Kentucky sits
The same service costs 5.9 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· 40th of 51
$1,000
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.