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 $407.38 Median $457.09 Typical High $794.33 | Facility | None | $407.38 | $457.09 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $588.84 | Professional | None | $371.54 | $407.38 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $10,715.19 | Facility | None | $3,235.94 | $5,370.32 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $707.95 | Professional | None | $407.38 | $562.34 | $707.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $354.81 Typical High $446.68 | Professional | 62 · Two surgeons | $257.04 | $354.81 | $446.68 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $91.20 Typical High $114.82 | Professional | 80 · Assistant surgeon | $64.57 | $91.20 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $79.43 Typical High $100.00 | Professional | AS · PA/NP assist | $56.23 | $79.43 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $457.09 Typical High $707.95 | Facility | None | $380.19 | $457.09 | $707.95 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $741.31 | Professional | None | $446.68 | $630.96 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $758.58 Typical High $794.33 | Facility | None | $34.67 | $758.58 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $3,090.30 | Professional | None | $457.09 | $676.08 | $3,090.30 |
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 $436.52 Median $537.03 Typical High $891.25 | Professional | None | $436.52 | $537.03 | $891.25 |
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 $181.97 Median $204.17 Typical High $234.42 | Professional | 52 · Reduced service | $181.97 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $93.33 | Professional | 53 · Discontinued | $72.44 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $354.81 | Professional | 54 · Surgery only | $275.42 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $70.79 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $46.77 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $46.77 |
Where Kentucky sits
The same service costs 3.4 times more in Alaska 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· 40th of 51
$562
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.