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 $234.42 Median $263.03 Typical High $794.33 | Facility | None | $234.42 | $263.03 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $288.40 | Professional | None | $213.80 | $234.42 | $288.40 |
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 $229.09 Median $288.40 Typical High $436.52 | Professional | None | $229.09 | $288.40 | $436.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $46.77 Typical High $69.18 | Professional | 80 · Assistant surgeon | $37.15 | $46.77 | $69.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $40.74 Typical High $61.66 | Professional | AS · PA/NP assist | $32.36 | $40.74 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $416.87 | Facility | None | $218.78 | $263.03 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $426.58 | Professional | None | $281.84 | $363.08 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $436.52 Typical High $794.33 | Facility | None | $34.67 | $436.52 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $1,819.70 | Professional | None | $269.15 | $389.05 | $1,819.70 |
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 $251.19 Median $309.03 Typical High $501.19 | Professional | None | $251.19 | $309.03 | $501.19 |
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 $104.71 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $104.71 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $42.66 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $177.83 Typical High $204.17 | Professional | 54 · Surgery only | $158.49 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.38 | $23.44 | $27.54 |
Where Kentucky sits
The same service costs 3.2 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· 48th of 51
$295
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.