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 $691.83 Median $851.14 Typical High $5,248.07 | Facility | None | $691.83 | $851.14 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $870.96 | Professional | None | $691.83 | $794.33 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,000.00 | Professional | None | $602.56 | $724.44 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $114.82 Typical High $158.49 | Professional | 80 · Assistant surgeon | $95.50 | $114.82 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $100.00 Typical High $138.04 | Professional | AS · PA/NP assist | $83.18 | $100.00 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $1,202.26 Typical High $2,691.53 | Facility | None | $724.44 | $1,202.26 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,230.27 | Professional | None | $812.83 | $1,000.00 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,659.59 Typical High $1,949.84 | Facility | None | $912.01 | $1,659.59 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $4,570.88 | Professional | None | $758.58 | $891.25 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $398.11 | Professional | None | $33.11 | $33.11 | $398.11 |
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 $676.08 Median $851.14 Typical High $1,348.96 | Professional | None | $676.08 | $851.14 | $1,348.96 |
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 $338.84 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $338.84 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $158.49 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $588.84 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $117.49 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $549.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $549.54 | $602.56 |
Where Kentucky sits
The same service costs 8.3 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
$759
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.