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 $616.60 Median $776.25 Typical High $8,511.38 | Facility | None | $616.60 | $776.25 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $776.25 | Professional | None | $616.60 | $707.95 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,778.28 | $4,677.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $870.96 | Professional | None | $537.03 | $660.69 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $107.15 Typical High $138.04 | Professional | 80 · Assistant surgeon | $87.10 | $107.15 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $93.33 Typical High $120.23 | Professional | AS · PA/NP assist | $75.86 | $93.33 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $1,071.52 Typical High $6,309.57 | Facility | None | $575.44 | $1,071.52 | $6,309.57 |
CareSource Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,122.02 | Professional | None | $741.31 | $912.01 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,090.30 Typical High $3,630.78 | Facility | None | $1,202.26 | $3,090.30 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $3,890.45 | Professional | None | $691.83 | $912.01 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $331.13 | Professional | None | $33.11 | $33.11 | $331.13 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,318.26 | Professional | None | $660.69 | $812.83 | $1,318.26 |
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 $309.03 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $309.03 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $125.89 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $501.19 | $537.03 |
Where Kentucky sits
The same service costs 17.4 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· 46th of 51
$724
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.