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 $562.34 Median $602.56 Typical High $8,511.38 | Facility | None | $562.34 | $602.56 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $676.08 | Professional | None | $549.54 | $602.56 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $11,220.18 | Facility | None | $758.58 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $537.03 | Professional | None | $398.11 | $467.74 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $707.95 Typical High $812.83 | Professional | 50 · Both sides | $588.84 | $707.95 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $17,782.79 | Facility | None | $575.44 | $933.25 | $17,782.79 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $977.24 | Professional | None | $645.65 | $831.76 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $977.24 Typical High $12,302.69 | Facility | None | $34.67 | $977.24 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $2,691.53 | Professional | None | $602.56 | $812.83 | $2,691.53 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,148.15 | Professional | None | $562.34 | $707.95 | $1,148.15 |
5 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 $275.42 Median $295.12 Typical High $338.84 | Professional | 52 · Reduced service | $275.42 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $134.90 | Professional | 53 · Discontinued | $109.65 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $67.61 |
Where Kentucky sits
The same service costs 11.7 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· 49th 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.