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 $436.52 Median $436.52 Typical High $8,511.38 | Facility | None | $436.52 | $436.52 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $630.96 | Professional | None | $436.52 | $457.09 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $630.96 | Professional | None | $380.19 | $489.78 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $724.44 Typical High $933.25 | Professional | 50 · Both sides | $562.34 | $724.44 | $933.25 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $676.08 Typical High $2,818.38 | Facility | None | $354.81 | $676.08 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $691.83 | Professional | None | $380.19 | $588.84 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,949.84 Typical High $2,290.87 | Facility | None | $741.31 | $1,949.84 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $2,691.53 | Professional | None | $426.58 | $645.65 | $2,691.53 |
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 $436.52 Median $588.84 Typical High $812.83 | Professional | None | $436.52 | $588.84 | $812.83 |
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 $218.78 Median $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $218.78 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $102.33 | Professional | 53 · Discontinued | $87.10 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $363.08 |
Where Kentucky sits
The same service costs 8.9 times more in Oklahoma 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· 47th of 51
$537
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.