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 $602.56 Median $741.31 Typical High $8,511.38 | Facility | None | $602.56 | $741.31 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $741.31 | Professional | None | $602.56 | $676.08 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $870.96 | Professional | None | $549.54 | $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 $123.03 | Professional | AS · PA/NP assist | $75.86 | $93.33 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $1,122.02 Typical High $1,995.26 | Facility | None | $645.65 | $1,122.02 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,071.52 | Professional | None | $588.84 | $870.96 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,148.15 Typical High $4,570.88 | Facility | None | $34.67 | $1,148.15 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $3,890.45 | Professional | None | $660.69 | $851.14 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $338.84 | Professional | None | $33.11 | $33.11 | $338.84 |
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 $616.60 Median $812.83 Typical High $1,230.27 | Professional | None | $616.60 | $812.83 | $1,230.27 |
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 $302.00 Median $338.84 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $138.04 Typical High $147.91 | Professional | 53 · Discontinued | $120.23 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $446.68 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $89.13 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $67.61 Typical High $74.13 | Professional | 56 · Pre-op care only | $60.26 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $416.87 | $478.63 | $524.81 |
Where Kentucky sits
The same service costs 19.1 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
$692
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.