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 $616.60 Median $794.33 Typical High $8,511.38 | Facility | None | $616.60 | $794.33 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $891.25 | Professional | None | $707.95 | $724.44 | $891.25 |
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 $524.81 Median $602.56 Typical High $758.58 | Professional | None | $524.81 | $602.56 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $95.50 Typical High $120.23 | Professional | 80 · Assistant surgeon | $83.18 | $95.50 | $120.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $83.18 Typical High $104.71 | Professional | AS · PA/NP assist | $72.44 | $83.18 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $1,071.52 Typical High $4,897.79 | Facility | None | $660.69 | $1,071.52 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,096.48 | Professional | None | $602.56 | $831.76 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $3,630.78 | Facility | None | $851.14 | $2,511.89 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $3,311.31 | Professional | None | $691.83 | $812.83 | $3,311.31 |
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 $933.25 Typical High $1,148.15 | Professional | None | $645.65 | $933.25 | $1,148.15 |
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 $354.81 Median $363.08 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $144.54 Typical High $177.83 | Professional | 53 · Discontinued | $141.25 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $537.03 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $537.03 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $107.15 Typical High $134.90 | Professional | 55 · Aftercare only | $104.71 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $89.13 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $616.60 |
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· 48th of 51
$646
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.