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 $389.05 Median $457.09 Typical High $794.33 | Facility | None | $389.05 | $457.09 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $512.86 | Professional | None | $389.05 | $426.58 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $9,120.11 | Facility | None | $1,621.81 | $2,691.53 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $676.08 | Professional | None | $346.74 | $416.87 | $676.08 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $218.78 Median $263.03 Typical High $426.58 | Professional | 62 · Two surgeons | $218.78 | $263.03 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $67.61 Typical High $107.15 | Professional | 80 · Assistant surgeon | $54.95 | $67.61 | $107.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $58.88 Typical High $93.33 | Professional | AS · PA/NP assist | $48.98 | $58.88 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $436.52 Typical High $691.83 | Facility | None | $371.54 | $436.52 | $691.83 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $724.44 | Professional | None | $398.11 | $602.56 | $724.44 |
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 $446.68 Median $616.60 Typical High $2,754.23 | Professional | None | $446.68 | $616.60 | $2,754.23 |
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 $467.74 Median $549.54 Typical High $812.83 | Professional | None | $467.74 | $549.54 | $812.83 |
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 $194.98 Median $213.80 Typical High $257.04 | Professional | 52 · Reduced service | $194.98 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $102.33 | Professional | 53 · Discontinued | $77.62 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $380.19 | Professional | 54 · Surgery only | $295.12 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $63.10 Typical High $77.62 | Professional | 55 · Aftercare only | $58.88 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $51.29 |
Where Kentucky sits
The same service costs 4.3 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· 50th of 51
$457
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.