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 $741.31 Typical High $1,000.00 | Facility | None | $478.63 | $741.31 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,174.90 | Professional | None | $724.44 | $812.83 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $776.25 | Professional | None | $407.38 | $489.78 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $77.62 Typical High $114.82 | Professional | 80 · Assistant surgeon | $64.57 | $77.62 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $69.18 Typical High $100.00 | Professional | AS · PA/NP assist | $56.23 | $69.18 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $691.83 Typical High $1,096.48 | Facility | None | $575.44 | $691.83 | $1,096.48 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,122.02 | Professional | None | $758.58 | $954.99 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,318.26 Typical High $1,949.84 | Facility | None | $34.67 | $1,318.26 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $3,630.78 | Professional | None | $691.83 | $1,174.90 | $3,630.78 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,380.38 | Professional | None | $588.84 | $891.25 | $1,380.38 |
6 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 $363.08 Median $407.38 Typical High $524.81 | Professional | 52 · Reduced service | $363.08 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $208.93 | Professional | 53 · Discontinued | $147.91 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $794.33 | Professional | 54 · Surgery only | $549.54 | $616.60 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $158.49 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $104.71 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $741.31 |
Where Kentucky sits
The same service costs 6.8 times more in Oklahoma 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
$617
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.