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 $2,511.89 Median $6,025.60 Typical High $6,025.60 | Facility | None | $2,511.89 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $6,025.60 Typical High $6,025.60 | Professional | None | $1,659.59 | $6,025.60 | $6,025.60 |
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 $616.60 Median $741.31 Typical High $891.25 | Professional | None | $616.60 | $741.31 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $117.49 Typical High $144.54 | Professional | 80 · Assistant surgeon | $97.72 | $117.49 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $102.33 Typical High $125.89 | Professional | AS · PA/NP assist | $85.11 | $102.33 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $467.74 Typical High $794.33 | Facility | None | $34.67 | $467.74 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $1,202.26 | Professional | None | $346.74 | $346.74 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 |
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 $831.76 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $831.76 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $1,230.27 Typical High $1,230.27 | Professional | 53 · Discontinued | $331.13 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $4,570.88 Typical High $4,570.88 | Professional | 54 · Surgery only | $1,230.27 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $245.47 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $165.96 | $602.56 | $602.56 |
Where Kentucky sits
The same service costs 204.2 times more in Wisconsin than in Hawaii. 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
$741
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.