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 $199.53 Median $245.47 Typical High $794.33 | Facility | None | $199.53 | $245.47 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $263.03 | Professional | None | $190.55 | $199.53 | $263.03 |
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 $181.97 Median $213.80 Typical High $323.59 | Professional | None | $181.97 | $213.80 | $323.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $114.82 Median $134.90 Typical High $204.17 | Professional | 62 · Two surgeons | $114.82 | $134.90 | $204.17 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.84 Median $33.88 Typical High $51.29 | Professional | 80 · Assistant surgeon | $28.84 | $33.88 | $51.29 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $25.70 Median $30.20 Typical High $45.71 | Professional | AS · PA/NP assist | $25.70 | $30.20 | $45.71 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $112,201.85 | Facility | None | $177.83 | $288.40 | $112,201.85 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $302.00 | Professional | None | $165.96 | $251.19 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $316.23 Typical High $794.33 | Facility | None | $34.67 | $316.23 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $891.25 | Professional | None | $186.21 | $302.00 | $891.25 |
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 $138.04 Median $208.93 Typical High $309.03 | Professional | None | $138.04 | $208.93 | $309.03 |
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 $144.54 Median $151.36 Typical High $194.98 | Professional | 54 · Surgery only | $144.54 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.20 Typical High $38.90 | Professional | 55 · Aftercare only | $28.84 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.95 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.05 | $19.95 | $25.70 |
Where Kentucky sits
The same service costs 10.5 times more in North Dakota than in Kentucky. 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· 51st of 51
$214
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.