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 $575.44 Median $691.83 Typical High $8,511.38 | Facility | None | $575.44 | $691.83 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $776.25 | Professional | None | $630.96 | $660.69 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $724.44 | Professional | None | $478.63 | $575.44 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $851.14 Typical High $1,071.52 | Professional | 50 · Both sides | $707.95 | $851.14 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $363.08 Typical High $457.09 | Professional | 62 · Two surgeons | $295.12 | $363.08 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $933.25 Typical High $2,691.53 | Facility | None | $489.78 | $933.25 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $954.99 | Professional | None | $524.81 | $812.83 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $2,511.89 | Facility | None | $954.99 | $1,995.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $3,019.95 | Professional | None | $575.44 | $794.33 | $3,019.95 |
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 $537.03 Median $630.96 Typical High $1,023.29 | Professional | None | $537.03 | $630.96 | $1,023.29 |
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 $316.23 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $316.23 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $128.82 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $478.63 |
Where Kentucky sits
The same service costs 8.5 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· 41st of 51
$661
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.