How much rates vary
Facilitymedian $955 · 10th to 90th $275 to $3,802Professionalmedian $263 · 10th to 90th $209 to $457
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 $218.78 Median $309.03 Typical High $794.33 | Facility | None | $218.78 | $309.03 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $467.74 | Professional | None | $218.78 | $309.03 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | None | $302.00 | $302.00 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $302.00 | Professional | None | $208.93 | $245.47 | $302.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $39.81 Typical High $48.98 | Professional | 80 · Assistant surgeon | $33.11 | $39.81 | $48.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $29.51 Median $34.67 Typical High $42.66 | Professional | AS · PA/NP assist | $29.51 | $34.67 | $42.66 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $426.58 | Facility | None | $234.42 | $331.13 | $426.58 |
CareSource Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $380.19 | Professional | None | $234.42 | $316.23 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $323.59 Typical High $426.58 | Facility | None | $34.67 | $323.59 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $1,905.46 | Professional | None | $245.47 | $338.84 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $177.83 | Professional | None | $33.11 | $33.11 | $177.83 |
United Setting Facility Modifier None Typical Low $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $524.81 | Professional | None | $263.03 | $346.74 | $524.81 |
12 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 Facility Modifier 52 · Reduced service Typical Low $109.65 Median $138.04 Typical High $190.55 | Facility | 52 · Reduced service | $109.65 | $138.04 | $190.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $44.67 Median $54.95 Typical High $75.86 | Facility | 53 · Discontinued | $44.67 | $54.95 | $75.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $165.96 Median $204.17 Typical High $281.84 | Facility | 54 · Surgery only | $165.96 | $204.17 | $281.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.11 Median $40.74 Typical High $57.54 | Facility | 55 · Aftercare only | $33.11 | $40.74 | $57.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.88 Median $27.54 Typical High $38.02 | Facility | 56 · Pre-op care only | $21.88 | $27.54 | $38.02 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $190.55 Typical High $263.03 | Facility | 78 · Unplanned return to OR | $154.88 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $144.54 Typical High $190.55 | Professional | 52 · Reduced service | $109.65 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $57.54 Typical High $75.86 | Professional | 53 · Discontinued | $44.67 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $213.80 Typical High $281.84 | Professional | 54 · Surgery only | $165.96 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $42.66 Typical High $57.54 | Professional | 55 · Aftercare only | $33.11 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $28.84 Typical High $38.02 | Professional | 56 · Pre-op care only | $21.88 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $199.53 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $154.88 | $199.53 | $263.03 |
Where Kentucky sits
The same service costs 4.5 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· 49th of 51
$269
AK $1,072TX $240
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.