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 $724.44 Median $891.25 Typical High $8,511.38 | Facility | None | $724.44 | $891.25 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,023.29 | Professional | None | $724.44 | $812.83 | $1,023.29 |
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 $707.95 Median $870.96 Typical High $1,288.25 | Professional | None | $707.95 | $870.96 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $138.04 Typical High $204.17 | Professional | 80 · Assistant surgeon | $114.82 | $138.04 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $120.23 Typical High $177.83 | Professional | AS · PA/NP assist | $100.00 | $120.23 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $1,258.93 Typical High $4,897.79 | Facility | None | $776.25 | $1,258.93 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,288.25 | Professional | None | $851.14 | $1,047.13 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $6,025.60 | Facility | None | $1,348.96 | $3,090.30 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $5,370.32 | Professional | None | $794.33 | $1,047.13 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $467.74 | Professional | None | $33.11 | $33.11 | $467.74 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,513.56 | Professional | None | $794.33 | $977.24 | $1,513.56 |
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 $354.81 Median $407.38 Typical High $512.86 | Professional | 52 · Reduced service | $354.81 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $208.93 | Professional | 53 · Discontinued | $144.54 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $616.60 Typical High $776.25 | Professional | 54 · Surgery only | $537.03 | $616.60 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $123.03 Typical High $154.88 | Professional | 55 · Aftercare only | $107.15 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $102.33 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $575.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $501.19 | $575.44 | $724.44 |
Where Kentucky sits
The same service costs 17.8 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· 41st of 51
$891
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.