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 $512.86 Median $524.81 Typical High $5,248.07 | Facility | None | $512.86 | $524.81 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $588.84 | Professional | None | $489.78 | $512.86 | $588.84 |
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 $363.08 Median $436.52 Typical High $602.56 | Professional | None | $363.08 | $436.52 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $660.69 Typical High $912.01 | Professional | 50 · Both sides | $537.03 | $660.69 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $707.95 Typical High $3,548.13 | Facility | None | $446.68 | $707.95 | $3,548.13 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $741.31 | Professional | None | $489.78 | $630.96 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,862.09 Typical High $2,630.27 | Facility | None | $741.31 | $1,862.09 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $2,754.23 | Professional | None | $426.58 | $630.96 | $2,754.23 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $831.76 | Professional | None | $407.38 | $467.74 | $831.76 |
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 $245.47 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $245.47 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $107.15 | Professional | 53 · Discontinued | $97.72 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $380.19 Typical High $398.11 | Professional | 54 · Surgery only | $371.54 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $79.43 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $354.81 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $346.74 | $354.81 | $371.54 |
Where Kentucky sits
The same service costs 7.9 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· 43rd of 51
$513
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.