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 $977.24 Median $1,318.26 Typical High $1,380.38 | Facility | None | $977.24 | $1,318.26 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,412.54 | Professional | None | $977.24 | $1,071.52 | $1,412.54 |
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 $794.33 Median $933.25 Typical High $1,318.26 | Professional | None | $794.33 | $933.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $151.36 Typical High $213.80 | Professional | 80 · Assistant surgeon | $128.82 | $151.36 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $131.83 Typical High $186.21 | Professional | AS · PA/NP assist | $112.20 | $131.83 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $912.01 Typical High $1,412.54 | Facility | None | $758.58 | $912.01 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,479.11 | Professional | None | $870.96 | $1,258.93 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $831.76 Typical High $1,584.89 | Facility | None | $34.67 | $831.76 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,737.80 Typical High $4,466.84 | Professional | None | $912.01 | $1,737.80 | $4,466.84 |
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 $1,174.90 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,584.89 | $1,995.26 |
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 $489.78 Median $537.03 Typical High $691.83 | Professional | 52 · Reduced service | $489.78 | $537.03 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $213.80 Typical High $281.84 | Professional | 53 · Discontinued | $194.98 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $741.31 | $812.83 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $208.93 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $107.15 Typical High $141.25 | Professional | 56 · Pre-op care only | $97.72 | $107.15 | $141.25 |
Where Kentucky sits
The same service costs 3.7 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· 49th of 51
$1,072
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.