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 $676.08 Median $851.14 Typical High $8,511.38 | Facility | None | $676.08 | $851.14 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $851.14 | Professional | None | $676.08 | $691.83 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,778.28 | $4,677.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $912.01 | Professional | None | $575.44 | $707.95 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $112.20 Typical High $147.91 | Professional | 80 · Assistant surgeon | $93.33 | $112.20 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $97.72 Typical High $128.82 | Professional | AS · PA/NP assist | $81.28 | $97.72 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $1,023.29 Typical High $4,897.79 | Facility | None | $630.96 | $1,023.29 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,023.29 | Professional | None | $616.60 | $776.25 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $3,090.30 Typical High $3,630.78 | Facility | None | $1,122.02 | $3,090.30 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $4,466.84 | Professional | None | $660.69 | $758.58 | $4,466.84 |
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 $645.65 Median $891.25 Typical High $1,096.48 | Professional | None | $645.65 | $891.25 | $1,096.48 |
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 $338.84 Median $346.74 Typical High $426.58 | Professional | 52 · Reduced service | $338.84 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $169.82 | Professional | 53 · Discontinued | $134.90 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $512.86 Typical High $645.65 | Professional | 54 · Surgery only | $501.19 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $102.33 Typical High $128.82 | Professional | 55 · Aftercare only | $100.00 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $478.63 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $467.74 | $478.63 | $602.56 |
Where Kentucky sits
The same service costs 6.3 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· 43rd of 51
$708
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.