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 $794.33 Median $870.96 Typical High $5,248.07 | Facility | None | $794.33 | $870.96 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $912.01 | Professional | None | $851.14 | $870.96 | $912.01 |
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 $562.34 Median $676.08 Typical High $851.14 | Professional | None | $562.34 | $676.08 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,023.29 Typical High $1,288.25 | Professional | 50 · Both sides | $831.76 | $1,023.29 | $1,288.25 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $1,202.26 Typical High $2,691.53 | Facility | None | $758.58 | $1,202.26 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,258.93 | Professional | None | $831.76 | $1,071.52 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $2,089.30 | Facility | None | $977.24 | $1,862.09 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $4,466.84 | Professional | None | $707.95 | $954.99 | $4,466.84 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,230.27 | Professional | None | $616.60 | $724.44 | $1,230.27 |
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 $426.58 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $426.58 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $181.97 | Professional | 53 · Discontinued | $169.82 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $630.96 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $87.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $85.11 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $588.84 | $602.56 | $630.96 |
Where Kentucky sits
The same service costs 8.3 times more in Wyoming 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· 42nd of 51
$813
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.