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 $309.03 Median $436.52 Typical High $794.33 | Facility | None | $309.03 | $436.52 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $549.54 | Professional | None | $416.87 | $436.52 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $407.38 | Professional | None | $194.98 | $269.15 | $407.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $123.03 Median $169.82 Typical High $257.04 | Professional | 62 · Two surgeons | $123.03 | $169.82 | $257.04 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $43.65 Typical High $66.07 | Professional | 80 · Assistant surgeon | $31.62 | $43.65 | $66.07 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $38.02 Typical High $57.54 | Professional | AS · PA/NP assist | $27.54 | $38.02 | $57.54 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $1,122.02 Typical High $1,995.26 | Facility | None | $407.38 | $1,122.02 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $676.08 | Professional | None | $416.87 | $575.44 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $794.33 Typical High $3,630.78 | Facility | None | $34.67 | $794.33 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $1,819.70 | Professional | None | $309.03 | $426.58 | $1,819.70 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $812.83 | Professional | None | $263.03 | $363.08 | $812.83 |
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 $213.80 Median $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $213.80 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $87.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $43.65 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $43.65 | $48.98 |
Where Kentucky sits
The same service costs 5.2 times more in Alaska than in Kentucky. 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· 51st of 51
$347
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.