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 $977.24 Median $1,513.56 Typical High $2,041.74 | Facility | None | $977.24 | $1,513.56 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,548.82 Typical High $2,238.72 | Professional | None | $977.24 | $1,548.82 | $2,238.72 |
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 $1,348.96 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,621.81 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $263.03 Typical High $346.74 | Professional | 80 · Assistant surgeon | $213.80 | $263.03 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $229.09 Typical High $309.03 | Professional | AS · PA/NP assist | $190.55 | $229.09 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,187.76 | Facility | None | $1,174.90 | $1,412.54 | $2,187.76 |
CareSource Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,513.56 | $1,905.46 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,454.71 | Facility | None | $34.67 | $512.86 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $6,760.83 Typical High $6,760.83 | Professional | None | $1,412.54 | $6,760.83 | $6,760.83 |
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 $1,659.59 Median $2,290.87 Typical High $2,884.03 | Professional | None | $1,659.59 | $2,290.87 | $2,884.03 |
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 $489.78 Median $831.76 Typical High $1,122.02 | Professional | 52 · Reduced service | $489.78 | $831.76 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $331.13 Typical High $446.68 | Professional | 53 · Discontinued | $194.98 | $331.13 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,230.27 Typical High $1,659.59 | Professional | 54 · Surgery only | $724.44 | $1,230.27 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $245.47 Typical High $331.13 | Professional | 55 · Aftercare only | $144.54 | $245.47 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $165.96 Typical High $223.87 | Professional | 56 · Pre-op care only | $97.72 | $165.96 | $223.87 |
Where Kentucky sits
The same service costs 4.7 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· 45th of 51
$1,622
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.