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 $489.78 Median $549.54 Typical High $8,511.38 | Facility | None | $489.78 | $549.54 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $630.96 | Professional | None | $478.63 | $524.81 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $831.76 | Professional | None | $436.52 | $562.34 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $89.13 Typical High $125.89 | Professional | 80 · Assistant surgeon | $69.18 | $89.13 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $77.62 Typical High $109.65 | Professional | AS · PA/NP assist | $60.26 | $77.62 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $812.83 Typical High $3,715.35 | Facility | None | $489.78 | $812.83 | $3,715.35 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $831.76 | Professional | None | $457.09 | $707.95 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $2,754.23 | Facility | None | $851.14 | $2,290.87 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $3,311.31 | Professional | None | $524.81 | $758.58 | $3,311.31 |
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 $501.19 Median $758.58 Typical High $1,023.29 | Professional | None | $501.19 | $758.58 | $1,023.29 |
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 $239.88 Median $263.03 Typical High $316.23 | Professional | 52 · Reduced service | $239.88 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $125.89 | Professional | 53 · Discontinued | $95.50 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $478.63 | Professional | 54 · Surgery only | $363.08 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $95.50 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $446.68 |
Where Kentucky sits
The same service costs 8.3 times more in Oklahoma 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
$631
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.