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 $851.14 Median $1,071.52 Typical High $1,348.96 | Facility | None | $851.14 | $1,071.52 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,148.15 | $1,348.96 |
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 $851.14 Median $1,000.00 Typical High $1,230.27 | Professional | None | $851.14 | $1,000.00 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $630.96 Typical High $776.25 | Professional | 62 · Two surgeons | $537.03 | $630.96 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $194.98 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $138.04 Typical High $169.82 | Professional | AS · PA/NP assist | $117.49 | $138.04 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,621.81 | Facility | None | $870.96 | $1,047.13 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,698.24 | Professional | None | $912.01 | $1,288.25 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,819.70 | Facility | None | $34.67 | $512.86 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $5,011.87 | Professional | None | $1,096.48 | $1,096.48 | $5,011.87 |
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 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $1,778.28 | Professional | None | $977.24 | $1,479.11 | $1,778.28 |
3 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 $812.83 Median $870.96 Typical High $1,023.29 | Professional | 54 · Surgery only | $812.83 | $870.96 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $204.17 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $134.90 |
Where Kentucky sits
The same service costs 5.6 times more in Alaska than in New York. 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
$1,023
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.