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 $3,388.44 Median $4,570.88 Typical High $5,011.87 | Facility | None | $3,388.44 | $4,570.88 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,715.35 Typical High $5,011.87 | Professional | None | $3,388.44 | $3,715.35 | $5,011.87 |
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 $2,290.87 Median $2,691.53 Typical High $3,467.37 | Professional | None | $2,290.87 | $2,691.53 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $426.58 Typical High $562.34 | Professional | 80 · Assistant surgeon | $363.08 | $426.58 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $380.19 Typical High $489.78 | Professional | AS · PA/NP assist | $316.23 | $380.19 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $5,011.87 | Facility | None | $2,630.27 | $3,162.28 | $5,011.87 |
CareSource Setting Professional Modifier None Typical Low $3,090.30 Median $4,365.16 Typical High $5,128.61 | Professional | None | $3,090.30 | $4,365.16 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $5,623.41 | Facility | None | $34.67 | $512.86 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $6,165.95 Typical High $15,135.61 | Professional | None | $3,162.28 | $6,165.95 | $15,135.61 |
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 $3,981.07 Median $5,248.07 Typical High $6,918.31 | Professional | None | $3,981.07 | $5,248.07 | $6,918.31 |
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 $1,698.24 Median $1,862.09 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,698.24 | $1,862.09 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $741.31 Typical High $1,000.00 | Professional | 53 · Discontinued | $676.08 | $741.31 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,818.38 Typical High $3,715.35 | Professional | 54 · Surgery only | $2,570.40 | $2,818.38 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $562.34 Typical High $741.31 | Professional | 55 · Aftercare only | $512.86 | $562.34 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $371.54 Typical High $501.19 | Professional | 56 · Pre-op care only | $338.84 | $371.54 | $501.19 |
Where Kentucky sits
The same service costs 7.4 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· 46th of 51
$3,236
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.