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 $776.25 Median $776.25 Typical High $8,511.38 | Facility | None | $776.25 | $776.25 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | None | $776.25 | $776.25 | $933.25 |
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 $660.69 Median $794.33 Typical High $1,174.90 | Professional | None | $660.69 | $794.33 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $190.55 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $112.20 Typical High $165.96 | Professional | AS · PA/NP assist | $93.33 | $112.20 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,398.83 | Facility | None | $1,258.93 | $1,621.81 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $2,290.87 | Facility | None | $1,047.13 | $1,230.27 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $4,897.79 | Professional | None | $758.58 | $1,174.90 | $4,897.79 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,445.44 | Professional | None | $741.31 | $1,000.00 | $1,445.44 |
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 $389.05 Median $389.05 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $660.69 |
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· 44th of 51
$912
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.