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 $891.25 Median $1,174.90 Typical High $8,511.38 | Facility | None | $891.25 | $1,174.90 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,047.13 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,318.26 | Professional | None | $851.14 | $1,071.52 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $169.82 Typical High $213.80 | Professional | 80 · Assistant surgeon | $138.04 | $169.82 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $147.91 Typical High $186.21 | Professional | AS · PA/NP assist | $120.23 | $147.91 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $4,897.79 | Facility | None | $954.99 | $1,584.89 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,584.89 | Professional | None | $954.99 | $1,174.90 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $3,630.78 | Facility | None | $1,698.24 | $2,511.89 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $9,549.93 | Professional | None | $1,000.00 | $1,148.15 | $9,549.93 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,348.96 | $1,698.24 |
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 $512.86 Median $524.81 Typical High $660.69 | Professional | 52 · Reduced service | $512.86 | $524.81 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $263.03 | Professional | 53 · Discontinued | $208.93 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $977.24 | Professional | 54 · Surgery only | $776.25 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $194.98 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $131.83 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $912.01 |
Where Kentucky sits
The same service costs 6.2 times more in Alaska than in Texas. 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· 44th of 51
$1,072
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.