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 $537.03 Median $537.03 Typical High $8,511.38 | Facility | None | $537.03 | $537.03 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $660.69 | Professional | None | $537.03 | $537.03 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $741.31 | Professional | None | $426.58 | $512.86 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $776.25 Typical High $1,096.48 | Professional | 50 · Both sides | $630.96 | $776.25 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $323.59 Typical High $467.74 | Professional | 62 · Two surgeons | $269.15 | $323.59 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $2,818.38 | Facility | None | $489.78 | $831.76 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $851.14 | Professional | None | $467.74 | $724.44 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,995.26 Typical High $2,511.89 | Facility | None | $933.25 | $1,995.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $2,884.03 | Professional | None | $524.81 | $758.58 | $2,884.03 |
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 $489.78 Median $660.69 Typical High $977.24 | Professional | None | $489.78 | $660.69 | $977.24 |
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 $269.15 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $269.15 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $107.15 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $398.11 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $398.11 |
Where Kentucky sits
The same service costs 8.7 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· 48th of 51
$575
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.