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 $398.11 Median $537.03 Typical High $3,235.94 | Facility | None | $398.11 | $537.03 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $2,818.38 | Professional | None | $398.11 | $467.74 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,120.11 Typical High $11,220.18 | Facility | None | $758.58 | $9,120.11 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,584.89 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,000.00 Typical High $1,380.38 | Professional | 62 · Two surgeons | $831.76 | $1,000.00 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $251.19 Typical High $346.74 | Professional | 80 · Assistant surgeon | $213.80 | $251.19 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $218.78 Typical High $309.03 | Professional | AS · PA/NP assist | $186.21 | $218.78 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $575.44 Typical High $112,201.85 | Facility | None | $354.81 | $575.44 | $112,201.85 |
CareSource Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $602.56 | Professional | None | $363.08 | $512.86 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $691.83 | Facility | None | $34.67 | $512.86 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,819.70 Typical High $1,819.70 | Professional | None | $398.11 | $1,819.70 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $100.00 | Professional | None | $44.67 | $44.67 | $100.00 |
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 $489.78 Typical High $724.44 | Professional | None | $331.13 | $489.78 | $724.44 |
3 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 54 · Surgery only Typical Low $302.00 Median $346.74 Typical High $478.63 | Professional | 54 · Surgery only | $302.00 | $346.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $69.18 Typical High $95.50 | Professional | 55 · Aftercare only | $60.26 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $46.77 Typical High $63.10 | Professional | 56 · Pre-op care only | $39.81 | $46.77 | $63.10 |
Where Kentucky sits
The same service costs 7.1 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· 5th of 51
$1,349
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.