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 $229.09 Median $851.14 Typical High $2,630.27 | Facility | None | $229.09 | $851.14 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $1,412.54 Typical High $2,630.27 | Professional | None | $223.87 | $1,412.54 | $2,630.27 |
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 $204.17 Median $1,023.29 Typical High $1,905.46 | Professional | None | $204.17 | $1,023.29 | $1,905.46 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $331.13 Typical High $1,621.81 | Facility | None | $177.83 | $331.13 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $338.84 | Professional | None | $190.55 | $288.40 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,096.48 Typical High $1,230.27 | Facility | None | $34.67 | $1,096.48 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $1,819.70 Typical High $11,481.54 | Professional | None | $208.93 | $1,819.70 | $11,481.54 |
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 $245.47 Median $1,230.27 Typical High $2,884.03 | Professional | None | $245.47 | $1,230.27 | $2,884.03 |
4 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 Facility Modifier 54 · Surgery only Typical Low $169.82 Median $213.80 Typical High $1,995.26 | Facility | 54 · Surgery only | $169.82 | $213.80 | $1,995.26 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $199.53 Typical High $1,862.09 | Facility | 78 · Unplanned return to OR | $158.49 | $199.53 | $1,862.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $229.09 Typical High $1,995.26 | Professional | 54 · Surgery only | $165.96 | $229.09 | $1,995.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $213.80 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $154.88 | $213.80 | $1,862.09 |
Where Kentucky sits
The same service costs 7.1 times more in Oregon 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· 45th of 51
$1,023
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.