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 $870.96 Median $891.25 Typical High $8,511.38 | Facility | None | $870.96 | $891.25 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,096.48 | Professional | None | $870.96 | $977.24 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $933.25 | Professional | None | $562.34 | $724.44 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $114.82 Typical High $154.88 | Professional | 80 · Assistant surgeon | $89.13 | $114.82 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $100.00 Typical High $131.83 | Professional | AS · PA/NP assist | $77.62 | $100.00 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $1,548.82 Typical High $2,691.53 | Facility | None | $812.83 | $1,548.82 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,584.89 | Professional | None | $954.99 | $1,318.26 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,511.89 | Facility | None | $1,698.24 | $1,905.46 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $4,677.35 | Professional | None | $912.01 | $1,230.27 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $331.13 | Professional | None | $33.11 | $33.11 | $331.13 |
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 $891.25 Median $1,174.90 Typical High $1,819.70 | Professional | None | $891.25 | $1,174.90 | $1,819.70 |
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 $436.52 Median $489.78 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $194.98 Typical High $218.78 | Professional | 53 · Discontinued | $173.78 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $724.44 Typical High $831.76 | Professional | 54 · Surgery only | $660.69 | $724.44 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $144.54 Typical High $165.96 | Professional | 55 · Aftercare only | $131.83 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $676.08 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $616.60 | $676.08 | $776.25 |
Where Kentucky sits
The same service costs 7.6 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
$832
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.