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 $234.42 Median $295.12 Typical High $794.33 | Facility | None | $234.42 | $295.12 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $302.00 | Professional | None | $234.42 | $239.88 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $6,025.60 Typical High $11,220.18 | Facility | None | $3,548.13 | $6,025.60 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $354.81 | Professional | None | $204.17 | $251.19 | $354.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $128.82 Median $158.49 Typical High $223.87 | Professional | 62 · Two surgeons | $128.82 | $158.49 | $223.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $39.81 Typical High $56.23 | Professional | 80 · Assistant surgeon | $33.11 | $39.81 | $56.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $28.84 Median $34.67 Typical High $48.98 | Professional | AS · PA/NP assist | $28.84 | $34.67 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $363.08 | Facility | None | $190.55 | $229.09 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $363.08 | Professional | None | $199.53 | $281.84 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $389.05 Typical High $794.33 | Facility | None | $34.67 | $389.05 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $1,513.56 | Professional | None | $229.09 | $281.84 | $1,513.56 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $380.19 | Professional | None | $223.87 | $309.03 | $380.19 |
5 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 $117.49 Median $120.23 Typical High $147.91 | Professional | 52 · Reduced service | $117.49 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $47.86 Typical High $60.26 | Professional | 53 · Discontinued | $46.77 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $223.87 | Professional | 54 · Surgery only | $177.83 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $44.67 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.99 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.44 | $23.99 | $30.20 |
Where Kentucky sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 41st of 51
$251
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.