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 $354.81 Median $398.11 Typical High $794.33 | Facility | None | $354.81 | $398.11 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $467.74 | Professional | None | $323.59 | $354.81 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $10,715.19 | Facility | None | $3,235.94 | $5,370.32 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $588.84 | Professional | None | $338.84 | $426.58 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $398.11 Typical High $630.96 | Facility | None | $331.13 | $398.11 | $630.96 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $645.65 | Professional | None | $389.05 | $549.54 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $794.33 | Facility | None | $34.67 | $512.86 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $2,398.83 | Professional | None | $407.38 | $575.44 | $2,398.83 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $758.58 | Professional | None | $363.08 | $446.68 | $758.58 |
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 $162.18 Median $177.83 Typical High $213.80 | Professional | 52 · Reduced service | $162.18 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $85.11 | Professional | 53 · Discontinued | $64.57 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $269.15 Typical High $316.23 | Professional | 54 · Surgery only | $239.88 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $47.86 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $42.66 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $251.19 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $223.87 | $251.19 | $295.12 |
Where Kentucky sits
The same service costs 5.0 times more in Alaska 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· 44th of 51
$427
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.