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 $741.31 Median $1,000.00 Typical High $1,047.13 | Facility | None | $741.31 | $1,000.00 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,047.13 | Professional | None | $741.31 | $812.83 | $1,047.13 |
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 $602.56 Median $707.95 Typical High $1,000.00 | Professional | None | $602.56 | $707.95 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $162.18 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $100.00 Typical High $141.25 | Professional | AS · PA/NP assist | $85.11 | $100.00 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $691.83 Typical High $1,071.52 | Facility | None | $575.44 | $691.83 | $1,071.52 |
CareSource Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,122.02 | Professional | None | $741.31 | $954.99 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $794.33 Typical High $1,202.26 | Facility | None | $34.67 | $794.33 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,318.26 Typical High $3,388.44 | Professional | None | $691.83 | $1,318.26 | $3,388.44 |
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 $891.25 Median $1,202.26 Typical High $1,513.56 | Professional | None | $891.25 | $1,202.26 | $1,513.56 |
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 $371.54 Median $407.38 Typical High $524.81 | Professional | 52 · Reduced service | $371.54 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $213.80 | Professional | 53 · Discontinued | $147.91 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $794.33 | Professional | 54 · Surgery only | $562.34 | $616.60 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $158.49 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $104.71 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $104.71 |
Where Kentucky sits
The same service costs 3.8 times more in Wisconsin 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· 49th of 51
$813
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.