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 $870.96 Median $954.99 Typical High $8,511.38 | Facility | None | $870.96 | $954.99 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,122.02 | Professional | None | $851.14 | $933.25 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,584.89 | $4,677.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,412.54 | Professional | None | $851.14 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,548.82 Typical High $2,137.96 | Professional | 50 · Both sides | $1,258.93 | $1,548.82 | $2,137.96 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $4,897.79 | Facility | None | $912.01 | $1,479.11 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,513.56 | Professional | None | $891.25 | $1,288.25 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $3,467.37 Typical High $4,168.69 | Facility | None | $1,584.89 | $3,467.37 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $5,888.44 | Professional | None | $954.99 | $1,412.54 | $5,888.44 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,862.09 | Professional | None | $870.96 | $1,071.52 | $1,862.09 |
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 $426.58 Median $467.74 Typical High $562.34 | Professional | 52 · Reduced service | $426.58 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $186.21 Typical High $223.87 | Professional | 53 · Discontinued | $169.82 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $851.14 | Professional | 54 · Surgery only | $645.65 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $169.82 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $794.33 |
Where Kentucky sits
The same service costs 7.2 times more in Oklahoma 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· 45th of 51
$1,072
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.