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 $446.68 Median $562.34 Typical High $5,248.07 | Facility | None | $446.68 | $562.34 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $741.31 | Professional | None | $446.68 | $512.86 | $741.31 |
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 $457.09 Median $588.84 Typical High $1,230.27 | Professional | None | $457.09 | $588.84 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $95.50 Typical High $199.53 | Professional | 80 · Assistant surgeon | $72.44 | $95.50 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $83.18 Typical High $173.78 | Professional | AS · PA/NP assist | $63.10 | $83.18 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $776.25 Typical High $2,691.53 | Facility | None | $416.87 | $776.25 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $812.83 | Professional | None | $537.03 | $660.69 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $1,949.84 | Facility | None | $588.84 | $1,659.59 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $6,606.93 | Professional | None | $501.19 | $724.44 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $295.12 | Professional | None | $33.11 | $33.11 | $295.12 |
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 $588.84 Median $691.83 Typical High $1,122.02 | Professional | None | $588.84 | $691.83 | $1,122.02 |
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 $223.87 Median $257.04 Typical High $331.13 | Professional | 52 · Reduced service | $223.87 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $131.83 | Professional | 53 · Discontinued | $91.20 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $389.05 Typical High $501.19 | Professional | 54 · Surgery only | $338.84 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $77.62 Typical High $100.00 | Professional | 55 · Aftercare only | $67.61 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $51.29 Typical High $66.07 | Professional | 56 · Pre-op care only | $44.67 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $363.08 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $316.23 | $363.08 | $467.74 |
Where Kentucky sits
The same service costs 6.6 times more in Alaska than in Utah. 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· 39th of 51
$603
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.