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 $478.63 Median $630.96 Typical High $794.33 | Facility | None | $478.63 | $630.96 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $724.44 | Professional | None | $478.63 | $512.86 | $724.44 |
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 $537.03 | Professional | None | $331.13 | $389.05 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $63.10 Typical High $87.10 | Professional | 80 · Assistant surgeon | $53.70 | $63.10 | $87.10 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $54.95 Typical High $75.86 | Professional | AS · PA/NP assist | $46.77 | $54.95 | $75.86 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $436.52 Typical High $691.83 | Facility | None | $363.08 | $436.52 | $691.83 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $707.95 | Professional | None | $389.05 | $602.56 | $707.95 |
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 $436.52 Median $851.14 Typical High $2,137.96 | Professional | None | $436.52 | $851.14 | $2,137.96 |
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 $575.44 Median $758.58 Typical High $954.99 | Professional | None | $575.44 | $758.58 | $954.99 |
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 $234.42 Median $257.04 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $144.54 | Professional | 53 · Discontinued | $95.50 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $537.03 | Professional | 54 · Surgery only | $354.81 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $107.15 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $72.44 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $72.44 |
Where Kentucky sits
The same service costs 4.0 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
$479
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.