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 $1,096.48 Median $1,174.90 Typical High $8,511.38 | Facility | None | $1,096.48 | $1,174.90 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,174.90 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $31,622.78 Typical High $39,810.72 | Facility | None | $5,370.32 | $31,622.78 | $39,810.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,445.44 | Professional | None | $912.01 | $1,096.48 | $1,445.44 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,584.89 | Facility | None | $851.14 | $1,023.29 | $1,584.89 |
CareSource Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,621.81 | Professional | None | $977.24 | $1,380.38 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $14,791.08 | Facility | None | $1,174.90 | $1,621.81 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,949.84 Typical High $4,677.35 | Professional | None | $1,023.29 | $1,949.84 | $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 $977.24 Median $2,570.40 Typical High $8,912.51 | Facility | None | $977.24 | $2,570.40 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,445.44 | $1,995.26 |
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 $549.54 Median $575.44 Typical High $660.69 | Professional | 52 · Reduced service | $549.54 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $912.01 |
Where Kentucky sits
The same service costs 8.9 times more in Oklahoma than in Texas. 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
$1,230
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.