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 $1,096.48 Median $1,819.70 Typical High $2,398.83 | Facility | None | $1,096.48 | $1,819.70 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,819.70 | $1,995.26 | $2,691.53 |
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 $2,344.23 Median $2,818.38 Typical High $3,715.35 | Professional | None | $2,344.23 | $2,818.38 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $457.09 Typical High $602.56 | Professional | 80 · Assistant surgeon | $371.54 | $457.09 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $398.11 Typical High $524.81 | Professional | AS · PA/NP assist | $323.59 | $398.11 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,630.27 | Facility | None | $1,412.54 | $1,698.24 | $2,630.27 |
CareSource Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,659.59 | $2,290.87 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,951.21 | Facility | None | $34.67 | $512.86 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $8,128.31 Typical High $8,128.31 | Professional | None | $1,698.24 | $8,128.31 | $8,128.31 |
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 $1,905.46 Median $2,570.40 Typical High $3,235.94 | Professional | None | $1,905.46 | $2,570.40 | $3,235.94 |
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 $549.54 Median $1,000.00 Typical High $1,348.96 | Professional | 52 · Reduced service | $549.54 | $1,000.00 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $398.11 Typical High $537.03 | Professional | 53 · Discontinued | $218.78 | $398.11 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,479.11 Typical High $1,995.26 | Professional | 54 · Surgery only | $812.83 | $1,479.11 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $295.12 Typical High $398.11 | Professional | 55 · Aftercare only | $162.18 | $295.12 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $199.53 Typical High $269.15 | Professional | 56 · Pre-op care only | $109.65 | $199.53 | $269.15 |
Where Kentucky sits
The same service costs 4.7 times more in Alaska than in South Carolina. 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· 22nd of 51
$2,630
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.