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 $1,071.52 Typical High $2,630.27 | Facility | None | $794.33 | $1,071.52 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,148.15 | Professional | None | $1,047.13 | $1,071.52 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,122.02 | Professional | None | $724.44 | $891.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,318.26 Typical High $1,698.24 | Professional | 50 · Both sides | $1,096.48 | $1,318.26 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $1,513.56 Typical High $2,691.53 | Facility | None | $933.25 | $1,513.56 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,548.82 | Professional | None | $954.99 | $1,318.26 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $2,290.87 | Facility | None | $1,174.90 | $1,949.84 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $4,677.35 | Professional | None | $870.96 | $1,258.93 | $4,677.35 |
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 $831.76 Median $954.99 Typical High $1,584.89 | Professional | None | $831.76 | $954.99 | $1,584.89 |
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 $524.81 Median $537.03 Typical High $562.34 | Professional | 52 · Reduced service | $524.81 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $223.87 | Professional | 53 · Discontinued | $208.93 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $851.14 | Professional | 54 · Surgery only | $776.25 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $112.20 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $794.33 |
Where Kentucky sits
The same service costs 7.2 times more in Alaska 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· 44th of 51
$977
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.