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 $776.25 Median $977.24 Typical High $2,630.27 | Facility | None | $776.25 | $977.24 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,047.13 | Professional | None | $776.25 | $891.25 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,709.64 | Facility | None | $954.99 | $2,884.03 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,258.93 | Professional | None | $741.31 | $891.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,318.26 Typical High $1,862.09 | Professional | 50 · Both sides | $1,096.48 | $1,318.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $144.54 Typical High $199.53 | Professional | 80 · Assistant surgeon | $117.49 | $144.54 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $125.89 Typical High $173.78 | Professional | AS · PA/NP assist | $102.33 | $125.89 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $1,348.96 Typical High $8,709.64 | Facility | None | $831.76 | $1,348.96 | $8,709.64 |
CareSource Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,412.54 | Professional | None | $776.25 | $1,148.15 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,737.80 | Facility | None | $1,023.29 | $1,023.29 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $426.58 | Professional | None | $33.11 | $33.11 | $426.58 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,584.89 | Professional | None | $831.76 | $1,047.13 | $1,584.89 |
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 $389.05 Median $446.68 Typical High $524.81 | Professional | 52 · Reduced service | $389.05 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $177.83 Typical High $213.80 | Professional | 53 · Discontinued | $154.88 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $794.33 | Professional | 54 · Surgery only | $588.84 | $660.69 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $117.49 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $77.62 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $741.31 |
Where Kentucky sits
The same service costs 17.4 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
$891
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.