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 $851.14 Median $1,096.48 Typical High $8,511.38 | Facility | None | $851.14 | $1,096.48 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,148.15 | Professional | None | $891.25 | $1,096.48 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,709.64 | Facility | None | $954.99 | $2,884.03 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,995.26 | Professional | None | $812.83 | $977.24 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $158.49 Typical High $316.23 | Professional | 80 · Assistant surgeon | $128.82 | $158.49 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $134.90 Typical High $275.42 | Professional | AS · PA/NP assist | $112.20 | $134.90 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $18,620.87 Typical High $28,183.83 | Facility | None | $1,096.48 | $18,620.87 | $28,183.83 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $19,498.45 Typical High $33,884.42 | Professional | None | $1,230.27 | $19,498.45 | $33,884.42 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,897.79 Typical High $5,623.41 | Facility | None | $794.33 | $4,897.79 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 $1,288.25 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,412.54 | $2,238.72 |
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 $446.68 Median $537.03 Typical High $575.44 | Professional | 52 · Reduced service | $446.68 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $218.78 Typical High $229.09 | Professional | 53 · Discontinued | $177.83 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $660.69 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $162.18 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $109.65 | $114.82 |
Where Kentucky sits
The same service costs 5.9 times more in Texas than in Kentucky. 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· 51st of 51
$977
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.