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 $891.25 Median $1,479.11 Typical High $8,511.38 | Facility | None | $891.25 | $1,479.11 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,348.96 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,380.38 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $218.78 Typical High $331.13 | Professional | 80 · Assistant surgeon | $181.97 | $218.78 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $190.55 Typical High $288.40 | Professional | AS · PA/NP assist | $158.49 | $190.55 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,089.30 | Facility | None | $1,096.48 | $1,318.26 | $2,089.30 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,698.24 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,238.72 Typical High $5,623.41 | Facility | None | $34.67 | $2,238.72 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $8,709.64 | Professional | None | $1,318.26 | $1,659.59 | $8,709.64 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $758.58 | Professional | None | $33.11 | $33.11 | $758.58 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,621.81 | $2,454.71 |
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 $588.84 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $588.84 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $269.15 Typical High $331.13 | Professional | 53 · Discontinued | $239.88 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,023.29 Typical High $1,230.27 | Professional | 54 · Surgery only | $891.25 | $1,023.29 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $204.17 Typical High $245.47 | Professional | 55 · Aftercare only | $177.83 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $134.90 Typical High $165.96 | Professional | 56 · Pre-op care only | $120.23 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $954.99 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $831.76 | $954.99 | $1,148.15 |
Where Kentucky sits
The same service costs 18.6 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· 43rd of 51
$1,413
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.