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 $128.82 Median $144.54 Typical High $3,801.89 | Facility | None | $128.82 | $144.54 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $288.40 | Professional | None | $125.89 | $138.04 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $2,884.03 | Facility | None | $588.84 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $323.59 | Professional | None | $194.98 | $234.42 | $323.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $123.03 Median $147.91 Typical High $204.17 | Professional | 62 · Two surgeons | $123.03 | $147.91 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $794.33 Typical High $1,148.15 | Facility | None | $602.56 | $794.33 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $575.44 Typical High $1,318.26 | Facility | None | $229.09 | $575.44 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $1,148.15 | Professional | None | $138.04 | $199.53 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
United Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $257.04 | Professional | None | $112.20 | $199.53 | $257.04 |
5 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 $63.10 Median $69.18 Typical High $75.86 | Professional | 52 · Reduced service | $63.10 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $27.54 Typical High $30.20 | Professional | 53 · Discontinued | $25.12 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 54 · Surgery only | $95.50 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.80 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.59 | $13.80 | $15.14 |
Where Kentucky sits
The same service costs 4.3 times more in Alaska than in New York. 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· 32nd of 51
$234
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.