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 $630.96 Median $776.25 Typical High $8,511.38 | Facility | None | $630.96 | $776.25 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $831.76 | Professional | None | $630.96 | $707.95 | $831.76 |
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 $588.84 Median $707.95 Typical High $1,023.29 | Professional | None | $588.84 | $707.95 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $112.20 Typical High $162.18 | Professional | 80 · Assistant surgeon | $93.33 | $112.20 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $100.00 Typical High $144.54 | Professional | AS · PA/NP assist | $81.28 | $100.00 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $1,096.48 Typical High $4,897.79 | Facility | None | $660.69 | $1,096.48 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,122.02 | Professional | None | $758.58 | $912.01 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $3,630.78 | Facility | None | $1,174.90 | $3,090.30 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $4,365.16 | Professional | None | $691.83 | $870.96 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $407.38 | Professional | None | $33.11 | $33.11 | $407.38 |
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 $831.76 Typical High $1,288.25 | Professional | None | $660.69 | $831.76 | $1,288.25 |
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 $316.23 Median $354.81 Typical High $416.87 | Professional | 52 · Reduced service | $316.23 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $141.25 Typical High $165.96 | Professional | 53 · Discontinued | $125.89 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $630.96 | Professional | 54 · Surgery only | $467.74 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $125.89 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $63.10 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $501.19 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $436.52 | $501.19 | $588.84 |
Where Kentucky sits
The same service costs 8.5 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· 43rd of 51
$759
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.