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 $1,148.15 Typical High $1,174.90 | Facility | None | $1,096.48 | $1,148.15 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,258.93 | Professional | None | $1,122.02 | $1,174.90 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $9,549.93 Typical High $11,748.98 | Facility | None | $2,238.72 | $9,549.93 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,148.15 | Professional | None | $977.24 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $794.33 Typical High $1,584.89 | Facility | None | $467.74 | $794.33 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $5,623.41 | Professional | None | $1,071.52 | $1,071.52 | $5,623.41 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,445.44 | $1,819.70 |
4 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 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $933.25 | Professional | 54 · Surgery only | $851.14 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $870.96 |
Where Kentucky sits
The same service costs 16.2 times more in Alaska 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· 34th of 51
$1,148
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.