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 $281.84 Median $316.23 Typical High $851.14 | Facility | None | $281.84 | $316.23 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $467.74 | Professional | None | $275.42 | $302.00 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,715.35 Typical High $10,715.19 | Facility | None | $1,202.26 | $3,715.35 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $575.44 | Professional | None | $263.03 | $407.38 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $165.96 Median $257.04 Typical High $363.08 | Professional | 62 · Two surgeons | $165.96 | $257.04 | $363.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $66.07 Typical High $91.20 | Professional | 80 · Assistant surgeon | $41.69 | $66.07 | $91.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $57.54 Typical High $81.28 | Professional | AS · PA/NP assist | $37.15 | $57.54 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $281.84 Median $467.74 Typical High $3,715.35 | Facility | None | $281.84 | $467.74 | $3,715.35 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $478.63 | Professional | None | $316.23 | $407.38 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,238.72 Typical High $2,818.38 | Facility | None | $489.78 | $2,238.72 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $2,454.71 | Professional | None | $295.12 | $512.86 | $2,454.71 |
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 $316.23 Median $524.81 Typical High $616.60 | Professional | None | $316.23 | $524.81 | $616.60 |
5 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 $138.04 Median $151.36 Typical High $181.97 | Professional | 52 · Reduced service | $138.04 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $204.17 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $36.31 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $36.31 |
Where Kentucky sits
The same service costs 10.0 times more in Oklahoma than in New York. 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· 40th of 51
$447
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.