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 $288.40 Median $363.08 Typical High $794.33 | Facility | None | $288.40 | $363.08 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $457.09 | Professional | None | $288.40 | $316.23 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $6,760.83 Typical High $11,220.18 | Facility | None | $758.58 | $6,760.83 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $478.63 | Professional | None | $239.88 | $309.03 | $478.63 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $151.36 Median $194.98 Typical High $302.00 | Professional | 62 · Two surgeons | $151.36 | $194.98 | $302.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $50.12 Typical High $75.86 | Professional | 80 · Assistant surgeon | $38.90 | $50.12 | $75.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.88 Median $43.65 Typical High $66.07 | Professional | AS · PA/NP assist | $33.88 | $43.65 | $66.07 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $416.87 | Facility | None | $223.87 | $269.15 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $426.58 | Professional | None | $257.04 | $363.08 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $457.09 Typical High $794.33 | Facility | None | $34.67 | $457.09 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $537.03 Typical High $1,905.46 | Professional | None | $269.15 | $537.03 | $1,905.46 |
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 $331.13 Median $446.68 Typical High $575.44 | Professional | None | $331.13 | $446.68 | $575.44 |
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 $144.54 Median $158.49 Typical High $204.17 | Professional | 52 · Reduced service | $144.54 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $63.10 Typical High $81.28 | Professional | 53 · Discontinued | $57.54 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $239.88 Typical High $302.00 | Professional | 54 · Surgery only | $213.80 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $47.86 Typical High $61.66 | Professional | 55 · Aftercare only | $42.66 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $31.62 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.84 | $31.62 | $40.74 |
Where Kentucky sits
The same service costs 3.9 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· 41st of 51
$363
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.