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 $457.09 Typical High $5,248.07 | Facility | None | $407.38 | $457.09 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $537.03 | Professional | None | $398.11 | $436.52 | $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 $354.81 Median $426.58 Typical High $602.56 | Professional | None | $354.81 | $426.58 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $676.08 Typical High $2,818.38 | Facility | None | $407.38 | $676.08 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $691.83 | Professional | None | $407.38 | $588.84 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,659.59 Typical High $2,089.30 | Facility | None | $707.95 | $1,659.59 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $2,454.71 | Professional | None | $436.52 | $602.56 | $2,454.71 |
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 $389.05 Median $602.56 Typical High $831.76 | Professional | None | $389.05 | $602.56 | $831.76 |
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 $199.53 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $199.53 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $93.33 | Professional | 53 · Discontinued | $79.43 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $346.74 | Professional | 54 · Surgery only | $302.00 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $309.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $281.84 | $309.03 | $323.59 |
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
$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.