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 $758.58 Median $851.14 Typical High $954.99 | Facility | None | $758.58 | $851.14 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $912.01 | Professional | None | $676.08 | $758.58 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $13,489.63 | Facility | None | $5,011.87 | $8,317.64 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,230.27 | Professional | None | $724.44 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $144.54 Typical High $199.53 | Professional | 80 · Assistant surgeon | $117.49 | $144.54 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $125.89 Typical High $173.78 | Professional | AS · PA/NP assist | $102.33 | $125.89 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $851.14 Typical High $1,318.26 | Facility | None | $707.95 | $851.14 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $1,380.38 | Professional | None | $812.83 | $1,174.90 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,412.54 | Facility | None | $34.67 | $691.83 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $5,011.87 | Professional | None | $851.14 | $1,202.26 | $5,011.87 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,584.89 | Professional | None | $758.58 | $954.99 | $1,584.89 |
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 $380.19 Typical High $446.68 | Professional | 52 · Reduced service | $338.84 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $676.08 | Professional | 54 · Surgery only | $512.86 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $134.90 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $67.61 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $630.96 |
Where Kentucky sits
The same service costs 6.6 times more in Alaska than in Texas. 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· 42nd 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.