How much rates vary
Facilitymedian $1,479 · 10th to 90th $151 to $7,586Professionalmedian $1,148 · 10th to 90th $129 to $2,818
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 $151.36 Median $851.14 Typical High $2,691.53 | Facility | None | $151.36 | $851.14 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $1,023.29 Typical High $2,691.53 | Professional | None | $151.36 | $1,023.29 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $1,288.25 Typical High $2,041.74 | Professional | None | $117.49 | $1,288.25 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.62 Median $208.93 Typical High $331.13 | Professional | 80 · Assistant surgeon | $18.62 | $208.93 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $16.60 Median $181.97 Typical High $288.40 | Professional | AS · PA/NP assist | $16.60 | $181.97 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $1,000.00 Typical High $1,778.28 | Facility | None | $131.83 | $1,000.00 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $229.09 | Professional | None | $125.89 | $194.98 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $234.42 Typical High $691.83 | Facility | None | $34.67 | $234.42 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $1,659.59 Typical High $8,317.64 | Professional | None | $144.54 | $1,659.59 | $8,317.64 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $213.80 Median $1,174.90 Typical High $3,311.31 | Professional | None | $213.80 | $1,174.90 | $3,311.31 |
10 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 Facility Modifier 52 · Reduced service Typical Low $75.86 Median $109.65 Typical High $1,348.96 | Facility | 52 · Reduced service | $75.86 | $109.65 | $1,348.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $43.65 Typical High $537.03 | Facility | 53 · Discontinued | $30.20 | $43.65 | $537.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $165.96 Typical High $2,041.74 | Facility | 54 · Surgery only | $114.82 | $165.96 | $2,041.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $33.11 Typical High $407.38 | Facility | 55 · Aftercare only | $22.91 | $33.11 | $407.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $269.15 | Facility | 56 · Pre-op care only | $15.14 | $21.88 | $269.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $120.23 Typical High $1,202.26 | Professional | 52 · Reduced service | $75.86 | $120.23 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $47.86 Typical High $478.63 | Professional | 53 · Discontinued | $30.20 | $47.86 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $181.97 Typical High $1,819.70 | Professional | 54 · Surgery only | $114.82 | $181.97 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $36.31 Typical High $363.08 | Professional | 55 · Aftercare only | $22.91 | $36.31 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.99 Typical High $239.88 | Professional | 56 · Pre-op care only | $15.14 | $23.99 | $239.88 |
Where Kentucky sits
The same service costs 11.2 times more in Oklahoma than in Hawaii. 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· 43rd of 51
$1,288
OK $2,818HI $251
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.