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 $426.58 Median $562.34 Typical High $794.33 | Facility | None | $426.58 | $562.34 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $645.65 | Professional | None | $426.58 | $467.74 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $512.86 | Professional | None | $331.13 | $389.05 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $63.10 Typical High $81.28 | Professional | 80 · Assistant surgeon | $53.70 | $63.10 | $81.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $54.95 Typical High $70.79 | Professional | AS · PA/NP assist | $46.77 | $54.95 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $398.11 Typical High $616.60 | Facility | None | $331.13 | $398.11 | $616.60 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $630.96 | Professional | None | $426.58 | $537.03 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $794.33 | Facility | None | $34.67 | $512.86 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $758.58 Typical High $1,905.46 | Professional | None | $398.11 | $758.58 | $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 $512.86 Median $691.83 Typical High $851.14 | Professional | None | $512.86 | $691.83 | $851.14 |
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 $213.80 Median $234.42 Typical High $323.59 | Professional | 52 · Reduced service | $213.80 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $128.82 | Professional | 53 · Discontinued | $85.11 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $478.63 | Professional | 54 · Surgery only | $316.23 | $346.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $95.50 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $64.57 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $64.57 |
Where Kentucky sits
The same service costs 4.1 times more in Wisconsin than in Kentucky. 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· 51st of 51
$427
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.