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 $234.42 Median $288.40 Typical High $8,511.38 | Facility | None | $234.42 | $288.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $354.81 | Professional | None | $234.42 | $263.03 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $12,022.64 | Facility | None | $1,202.26 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $457.09 | Professional | None | $234.42 | $288.40 | $457.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $47.86 Typical High $72.44 | Professional | 80 · Assistant surgeon | $37.15 | $47.86 | $72.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $41.69 Typical High $64.57 | Professional | AS · PA/NP assist | $32.36 | $41.69 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $1,122.02 Typical High $1,995.26 | Facility | None | $239.88 | $1,122.02 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $416.87 | Professional | None | $275.42 | $338.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $794.33 Typical High $2,511.89 | Facility | None | $416.87 | $794.33 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $1,862.09 | Professional | None | $257.04 | $346.74 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $218.78 | Professional | None | $33.11 | $33.11 | $218.78 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $489.78 | Professional | None | $275.42 | $331.13 | $489.78 |
5 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 $117.49 Median $131.83 Typical High $169.82 | Professional | 52 · Reduced service | $117.49 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $52.48 Typical High $67.61 | Professional | 53 · Discontinued | $46.77 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $199.53 Typical High $257.04 | Professional | 54 · Surgery only | $173.78 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $39.81 Typical High $51.29 | Professional | 55 · Aftercare only | $34.67 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $26.30 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.44 | $26.30 | $33.88 |
Where Kentucky sits
The same service costs 4.8 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· 41st of 51
$295
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.