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 $1,380.38 Median $1,819.70 Typical High $2,238.72 | Facility | None | $1,380.38 | $1,819.70 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,380.38 | $1,513.56 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $11,220.18 | Facility | None | $758.58 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,513.56 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $245.47 Typical High $346.74 | Professional | 80 · Assistant surgeon | $186.21 | $245.47 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $213.80 Typical High $302.00 | Professional | AS · PA/NP assist | $162.18 | $213.80 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,995.26 | Facility | None | $1,047.13 | $1,258.93 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,737.80 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,238.72 | Facility | None | $34.67 | $512.86 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,244.36 | Professional | None | $1,288.25 | $2,511.89 | $7,244.36 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $2,884.03 | Professional | None | $1,905.46 | $2,570.40 | $2,884.03 |
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 $691.83 Median $758.58 Typical High $1,071.52 | Professional | 52 · Reduced service | $691.83 | $758.58 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $436.52 | Professional | 53 · Discontinued | $275.42 | $302.00 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $323.59 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $218.78 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $218.78 |
Where Kentucky sits
The same service costs 3.9 times more in Alaska than in Arkansas. 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
$1,622
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.