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 $831.76 Median $977.24 Typical High $1,000.00 | Facility | None | $831.76 | $977.24 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,023.29 | Professional | None | $831.76 | $912.01 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $9,120.11 | Facility | None | $1,621.81 | $2,691.53 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,318.26 | Professional | None | $758.58 | $912.01 | $1,318.26 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $1,479.11 | Facility | None | $794.33 | $954.99 | $1,479.11 |
CareSource Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $1,548.82 | Professional | None | $851.14 | $1,288.25 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,737.80 | Facility | None | $34.67 | $512.86 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $5,248.07 | Professional | None | $954.99 | $1,318.26 | $5,248.07 |
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 $954.99 Median $1,230.27 Typical High $1,778.28 | Professional | None | $954.99 | $1,230.27 | $1,778.28 |
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 $416.87 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $416.87 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $181.97 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $676.08 Typical High $758.58 | Professional | 54 · Surgery only | $630.96 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $83.18 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $630.96 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $588.84 | $630.96 | $707.95 |
Where Kentucky sits
The same service costs 7.4 times more in Alaska than in Texas. 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
$977
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.