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 $562.34 Median $691.83 Typical High $3,801.89 | Facility | None | $562.34 | $691.83 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $851.14 | Professional | None | $562.34 | $645.65 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $933.25 | Professional | None | $489.78 | $602.56 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $95.50 Typical High $147.91 | Professional | 80 · Assistant surgeon | $77.62 | $95.50 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $83.18 Typical High $128.82 | Professional | AS · PA/NP assist | $67.61 | $83.18 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $2,691.53 | Facility | None | $602.56 | $977.24 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,000.00 | Professional | None | $660.69 | $812.83 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $1,949.84 | Facility | None | $758.58 | $1,318.26 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $4,570.88 | Professional | None | $630.96 | $758.58 | $4,570.88 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,096.48 | Professional | None | $562.34 | $707.95 | $1,096.48 |
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 $281.84 Median $323.59 Typical High $426.58 | Professional | 52 · Reduced service | $281.84 | $323.59 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $128.82 Typical High $169.82 | Professional | 53 · Discontinued | $112.20 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $489.78 Typical High $645.65 | Professional | 54 · Surgery only | $416.87 | $489.78 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $97.72 Typical High $128.82 | Professional | 55 · Aftercare only | $83.18 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $64.57 Typical High $85.11 | Professional | 56 · Pre-op care only | $56.23 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $457.09 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $389.05 | $457.09 | $602.56 |
Where Kentucky sits
The same service costs 7.8 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· 44th of 51
$646
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.