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 $616.60 Typical High $2,630.27 | Facility | None | $575.44 | $616.60 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $676.08 | Professional | None | $562.34 | $616.60 | $676.08 |
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 $512.86 Median $630.96 Typical High $891.25 | Professional | None | $512.86 | $630.96 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $933.25 Typical High $1,348.96 | Professional | 50 · Both sides | $776.25 | $933.25 | $1,348.96 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $1,122.02 | Facility | None | $512.86 | $851.14 | $1,122.02 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,000.00 | Professional | None | $602.56 | $851.14 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $812.83 Typical High $2,290.87 | Facility | None | $691.83 | $812.83 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $3,311.31 | Professional | None | $616.60 | $912.01 | $3,311.31 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,202.26 | Professional | None | $588.84 | $707.95 | $1,202.26 |
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 $281.84 Median $309.03 Typical High $316.23 | Professional | 52 · Reduced service | $281.84 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $125.89 | Professional | 53 · Discontinued | $112.20 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $478.63 | Professional | 54 · Surgery only | $416.87 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $95.50 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $63.10 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $446.68 |
Where Kentucky sits
The same service costs 5.9 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· 48th 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.