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 $537.03 Typical High $8,511.38 | Facility | None | $512.86 | $537.03 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $707.95 | Professional | None | $501.19 | $524.81 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $707.95 | Professional | None | $389.05 | $467.74 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $707.95 Typical High $1,071.52 | Professional | 50 · Both sides | $588.84 | $707.95 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $724.44 Typical High $2,691.53 | Facility | None | $457.09 | $724.44 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $741.31 | Professional | None | $457.09 | $630.96 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,995.26 Typical High $2,290.87 | Facility | None | $741.31 | $1,995.26 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $3,890.45 | Professional | None | $436.52 | $660.69 | $3,890.45 |
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 $436.52 Median $478.63 Typical High $812.83 | Professional | None | $436.52 | $478.63 | $812.83 |
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 $251.19 Median $263.03 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $478.63 | Professional | 54 · Surgery only | $371.54 | $389.05 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $446.68 |
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· 42nd of 51
$525
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.