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 $691.83 Median $831.76 Typical High $8,511.38 | Facility | None | $691.83 | $831.76 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $870.96 | Professional | None | $758.58 | $794.33 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,677.35 Typical High $9,332.54 | Facility | None | $2,137.96 | $4,677.35 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $870.96 | Professional | None | $524.81 | $602.56 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $912.01 Typical High $1,288.25 | Professional | 50 · Both sides | $776.25 | $912.01 | $1,288.25 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $1,122.02 Typical High $2,041.74 | Facility | None | $588.84 | $1,122.02 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,148.15 | Professional | None | $758.58 | $977.24 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $4,168.69 | Facility | None | $1,148.15 | $1,445.44 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $3,548.13 | Professional | None | $645.65 | $912.01 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $588.84 Typical High $588.84 | Professional | None | $33.11 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,230.27 Typical High $3,890.45 | Facility | None | $707.95 | $1,230.27 | $3,890.45 |
United Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,258.93 | Professional | None | $616.60 | $707.95 | $1,258.93 |
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 $380.19 Median $398.11 Typical High $416.87 | Professional | 52 · Reduced service | $380.19 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $158.49 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $575.44 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $123.03 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $83.18 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $549.54 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $537.03 | $549.54 | $575.44 |
Where Kentucky sits
The same service costs 4.6 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· 49th of 51
$724
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.