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 $616.60 Median $616.60 Typical High $5,248.07 | Facility | None | $616.60 | $616.60 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $794.33 | Professional | None | $616.60 | $616.60 | $794.33 |
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 $489.78 Median $588.84 Typical High $794.33 | Professional | None | $489.78 | $588.84 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $93.33 Typical High $128.82 | Professional | 80 · Assistant surgeon | $77.62 | $93.33 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $83.18 Typical High $112.20 | Professional | AS · PA/NP assist | $67.61 | $83.18 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $4,897.79 | Facility | None | $575.44 | $933.25 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $954.99 | Professional | None | $537.03 | $812.83 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,659.59 Typical High $3,630.78 | Facility | None | $741.31 | $1,659.59 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $3,235.94 | Professional | None | $602.56 | $831.76 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $549.54 Median $758.58 Typical High $1,122.02 | Professional | None | $549.54 | $758.58 | $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 $309.03 Median $309.03 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $91.20 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $436.52 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $436.52 | $501.19 |
Where Kentucky sits
The same service costs 8.1 times more in Oklahoma 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· 47th of 51
$631
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.