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 $549.54 Median $691.83 Typical High $8,511.38 | Facility | None | $549.54 | $691.83 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $691.83 | Professional | None | $549.54 | $630.96 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,071.52 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $758.58 | Professional | None | $512.86 | $602.56 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $95.50 Typical High $123.03 | Professional | 80 · Assistant surgeon | $81.28 | $95.50 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $83.18 Typical High $104.71 | Professional | AS · PA/NP assist | $70.79 | $83.18 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $4,897.79 | Facility | None | $602.56 | $977.24 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,000.00 | Professional | None | $549.54 | $812.83 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,290.87 Typical High $3,630.78 | Facility | None | $1,071.52 | $2,290.87 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $3,019.95 | Professional | None | $616.60 | $831.76 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $257.04 | Professional | None | $33.11 | $33.11 | $257.04 |
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 $1,148.15 | Professional | None | $660.69 | $812.83 | $1,148.15 |
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 $275.42 Median $316.23 Typical High $346.74 | Professional | 52 · Reduced service | $275.42 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $109.65 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $416.87 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $54.95 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $478.63 |
Where Kentucky sits
The same service costs 8.1 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
$617
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.