How much rates vary
Facilitymedian $1,230 · 10th to 90th $676 to $9,120Professionalmedian $891 · 10th to 90th $676 to $1,349
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 $676.08 Median $831.76 Typical High $3,801.89 | Facility | None | $676.08 | $831.76 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,000.00 | Professional | None | $676.08 | $776.25 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,348.96 | Professional | None | $691.83 | $891.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $141.25 Typical High $213.80 | Professional | 80 · Assistant surgeon | $112.20 | $141.25 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $123.03 Typical High $186.21 | Professional | AS · PA/NP assist | $97.72 | $123.03 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $758.58 Typical High $1,174.90 | Facility | None | $630.96 | $758.58 | $1,174.90 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,202.26 | Professional | None | $676.08 | $1,000.00 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $831.76 Typical High $1,230.27 | Facility | None | $34.67 | $831.76 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $11,481.54 | Professional | None | $758.58 | $1,047.13 | $11,481.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $416.87 | Professional | None | $33.11 | $33.11 | $416.87 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $9,772.37 | Facility | None | $977.24 | $1,862.09 | $9,772.37 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,445.44 | Professional | None | $794.33 | $1,000.00 | $1,445.44 |
5 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 $338.84 Median $389.05 Typical High $489.78 | Professional | 52 · Reduced service | $338.84 | $389.05 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $154.88 Typical High $199.53 | Professional | 53 · Discontinued | $134.90 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $741.31 | Professional | 54 · Surgery only | $512.86 | $575.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $147.91 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $77.62 Typical High $100.00 | Professional | 56 · Pre-op care only | $67.61 | $77.62 | $100.00 |
Where Kentucky sits
The same service costs 4.6 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $9,843KY $2,122
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.