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 $2,511.89 Median $3,311.31 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,311.31 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $3,235.94 Typical High $3,981.07 | Professional | None | $2,511.89 | $3,235.94 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $4,570.88 | Professional | None | $3,311.31 | $3,890.45 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $630.96 Typical High $724.44 | Professional | 80 · Assistant surgeon | $537.03 | $630.96 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $549.54 Typical High $630.96 | Professional | AS · PA/NP assist | $467.74 | $549.54 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $3,630.78 | Facility | None | $1,949.84 | $2,344.23 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $3,715.35 | Professional | None | $2,290.87 | $3,162.28 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $4,466.84 | Facility | None | $34.67 | $512.86 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $11,748.98 Typical High $11,748.98 | Professional | None | $2,398.83 | $11,748.98 | $11,748.98 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 $2,511.89 Median $3,630.78 Typical High $4,897.79 | Professional | None | $2,511.89 | $3,630.78 | $4,897.79 |
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 $1,258.93 Median $1,621.81 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,258.93 | $1,621.81 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $645.65 Typical High $794.33 | Professional | 53 · Discontinued | $501.19 | $645.65 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,398.83 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,862.09 | $2,398.83 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $478.63 Typical High $588.84 | Professional | 55 · Aftercare only | $371.54 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $323.59 Typical High $398.11 | Professional | 56 · Pre-op care only | $251.19 | $323.59 | $398.11 |
Where Kentucky sits
The same service costs 7.1 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· 21st of 51
$3,890
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.