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 $1,348.96 Median $1,584.89 Typical High $1,698.24 | Facility | None | $1,348.96 | $1,584.89 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,479.11 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,479.11 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $933.25 Typical High $1,380.38 | Professional | 62 · Two surgeons | $758.58 | $933.25 | $1,380.38 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $5,248.07 | Facility | None | $1,412.54 | $2,398.83 | $5,248.07 |
CareSource Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,513.56 | $2,137.96 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,511.89 Typical High $2,754.23 | Facility | None | $34.67 | $2,511.89 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $8,912.51 | Professional | None | $1,548.82 | $2,290.87 | $8,912.51 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,995.26 | $2,884.03 |
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 $676.08 Median $741.31 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,174.90 |
Where Kentucky sits
The same service costs 6.6 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· 46th of 51
$1,585
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.