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 $416.87 Median $616.60 Typical High $2,630.27 | Facility | None | $416.87 | $616.60 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $630.96 | Professional | None | $501.19 | $602.56 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $11,220.18 | Facility | None | $758.58 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $398.11 | Professional | None | $204.17 | $302.00 | $398.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $128.82 Median $190.55 Typical High $251.19 | Professional | 62 · Two surgeons | $128.82 | $190.55 | $251.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $48.98 Typical High $64.57 | Professional | 80 · Assistant surgeon | $33.11 | $48.98 | $64.57 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $28.84 Median $42.66 Typical High $56.23 | Professional | AS · PA/NP assist | $28.84 | $42.66 | $56.23 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $478.63 Typical High $758.58 | Facility | None | $398.11 | $478.63 | $758.58 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $758.58 | Professional | None | $426.58 | $588.84 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $4,073.80 Typical High $12,022.64 | Facility | None | $34.67 | $4,073.80 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $2,187.76 | Professional | None | $602.56 | $602.56 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $100.00 | Professional | None | $44.67 | $48.98 | $100.00 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,162.28 Typical High $13,489.63 | Facility | None | $1,148.15 | $3,162.28 | $13,489.63 |
United Setting Professional Modifier None Typical Low $354.81 Median $645.65 Typical High $1,513.56 | Professional | None | $354.81 | $645.65 | $1,513.56 |
2 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 54 · Surgery only Typical Low $371.54 Median $446.68 Typical High $467.74 | Professional | 54 · Surgery only | $371.54 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $416.87 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $346.74 | $416.87 | $436.52 |
Where Kentucky sits
The same service costs 8.3 times more in South Dakota 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
$339
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.