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 $724.44 Median $812.83 Typical High $8,511.38 | Facility | None | $724.44 | $812.83 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $954.99 | Professional | None | $707.95 | $776.25 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,890.45 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,023.29 | Professional | None | $660.69 | $794.33 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $125.89 Typical High $162.18 | Professional | 80 · Assistant surgeon | $107.15 | $125.89 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $109.65 Typical High $141.25 | Professional | AS · PA/NP assist | $93.33 | $109.65 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $1,202.26 Typical High $8,317.64 | Facility | None | $724.44 | $1,202.26 | $8,317.64 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,230.27 | Professional | None | $758.58 | $1,047.13 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,288.25 Typical High $6,165.95 | Facility | None | $34.67 | $1,288.25 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $3,467.37 | Professional | None | $776.25 | $1,071.52 | $3,467.37 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,513.56 | Professional | None | $794.33 | $1,148.15 | $1,513.56 |
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 $354.81 Median $389.05 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $645.65 | Professional | 54 · Surgery only | $537.03 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $128.82 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $602.56 |
Where Kentucky sits
The same service costs 11.0 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· 46th of 51
$871
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.