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 $457.09 Median $467.74 Typical High $2,630.27 | Facility | None | $457.09 | $467.74 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $630.96 | Professional | None | $457.09 | $467.74 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,120.11 Typical High $11,220.18 | Facility | None | $758.58 | $9,120.11 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $812.83 | Professional | None | $407.38 | $512.86 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $83.18 Typical High $128.82 | Professional | 80 · Assistant surgeon | $64.57 | $83.18 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $72.44 Typical High $112.20 | Professional | AS · PA/NP assist | $56.23 | $72.44 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $446.68 Typical High $707.95 | Facility | None | $371.54 | $446.68 | $707.95 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $724.44 | Professional | None | $426.58 | $616.60 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $794.33 Typical High $6,165.95 | Facility | None | $34.67 | $794.33 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $3,311.31 | Professional | None | $446.68 | $707.95 | $3,311.31 |
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 $457.09 Median $645.65 Typical High $870.96 | Professional | None | $457.09 | $645.65 | $870.96 |
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 $229.09 Median $234.42 Typical High $302.00 | Professional | 52 · Reduced service | $229.09 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $93.33 Typical High $120.23 | Professional | 53 · Discontinued | $91.20 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $446.68 | Professional | 54 · Surgery only | $346.74 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $89.13 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $60.26 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $60.26 |
Where Kentucky sits
The same service costs 3.9 times more in Alaska than in New York. 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· 48th of 51
$537
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.