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 $239.88 Median $302.00 Typical High $794.33 | Facility | None | $239.88 | $302.00 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $245.47 Typical High $302.00 | Professional | None | $239.88 | $245.47 | $302.00 |
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 $194.98 Median $229.09 Typical High $281.84 | Professional | None | $194.98 | $229.09 | $281.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $123.03 Median $144.54 Typical High $177.83 | Professional | 62 · Two surgeons | $123.03 | $144.54 | $177.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $37.15 Typical High $44.67 | Professional | 80 · Assistant surgeon | $31.62 | $37.15 | $44.67 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $32.36 Typical High $39.81 | Professional | AS · PA/NP assist | $27.54 | $32.36 | $39.81 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $363.08 Typical High $112,201.85 | Facility | None | $218.78 | $363.08 | $112,201.85 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $363.08 | Professional | None | $204.17 | $275.42 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $398.11 Typical High $794.33 | Facility | None | $34.67 | $398.11 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $1,348.96 | Professional | None | $234.42 | $234.42 | $1,348.96 |
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 $199.53 Median $309.03 Typical High $489.78 | Professional | None | $199.53 | $309.03 | $489.78 |
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 $177.83 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $177.83 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $35.48 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.99 | $24.55 | $30.20 |
Where Kentucky sits
The same service costs 8.1 times more in New York than in Missouri. 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· 49th of 51
$234
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.