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 $676.08 Median $676.08 Typical High $8,511.38 | Facility | None | $676.08 | $676.08 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $912.01 | Professional | None | $676.08 | $691.83 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,071.52 | Professional | None | $588.84 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $123.03 Typical High $169.82 | Professional | 80 · Assistant surgeon | $93.33 | $123.03 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $107.15 Typical High $151.36 | Professional | AS · PA/NP assist | $81.28 | $107.15 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $1,047.13 Typical High $2,818.38 | Facility | None | $630.96 | $1,047.13 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,071.52 | Professional | None | $645.65 | $912.01 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,949.84 Typical High $2,290.87 | Facility | None | $794.33 | $1,949.84 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $4,786.30 | Professional | None | $660.69 | $1,023.29 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,288.25 | Professional | None | $676.08 | $933.25 | $1,288.25 |
6 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 $338.84 Median $338.84 Typical High $457.09 | Professional | 52 · Reduced service | $338.84 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | 53 · Discontinued | $134.90 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $676.08 | Professional | 54 · Surgery only | $512.86 | $512.86 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $134.90 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $91.20 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $630.96 |
Where Kentucky sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 39th of 51
$851
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.