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 $467.74 Median $588.84 Typical High $2,754.23 | Facility | None | $467.74 | $588.84 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $588.84 | Professional | None | $467.74 | $478.63 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $446.68 | Professional | None | $288.40 | $338.84 | $446.68 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $181.97 Median $213.80 Typical High $281.84 | Professional | 62 · Two surgeons | $181.97 | $213.80 | $281.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $53.70 Typical High $72.44 | Professional | 80 · Assistant surgeon | $45.71 | $53.70 | $72.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $46.77 Typical High $63.10 | Professional | AS · PA/NP assist | $39.81 | $46.77 | $63.10 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $457.09 Typical High $707.95 | Facility | None | $380.19 | $457.09 | $707.95 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $707.95 | Professional | None | $398.11 | $562.34 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $794.33 | Facility | None | $34.67 | $512.86 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $2,187.76 | Professional | None | $457.09 | $457.09 | $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 $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 $389.05 Median $630.96 Typical High $741.31 | Professional | None | $389.05 | $630.96 | $741.31 |
4 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 $346.74 Median $363.08 Typical High $446.68 | Professional | 54 · Surgery only | $346.74 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $89.13 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $58.88 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $338.84 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $323.59 | $338.84 | $416.87 |
Where Kentucky sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 50th of 51
$347
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.