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 $173.78 Median $199.53 Typical High $794.33 | Facility | None | $173.78 | $199.53 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $239.88 | Professional | None | $173.78 | $186.21 | $239.88 |
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 $162.18 Median $204.17 Typical High $302.00 | Professional | None | $162.18 | $204.17 | $302.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $102.33 Median $128.82 Typical High $190.55 | Professional | 62 · Two surgeons | $102.33 | $128.82 | $190.55 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.70 Median $31.62 Typical High $48.98 | Professional | 80 · Assistant surgeon | $25.70 | $31.62 | $48.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $22.91 Median $28.84 Typical High $42.66 | Professional | AS · PA/NP assist | $22.91 | $28.84 | $42.66 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $194.98 Typical High $309.03 | Facility | None | $162.18 | $194.98 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $316.23 | Professional | None | $190.55 | $257.04 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $331.13 Typical High $794.33 | Facility | None | $34.67 | $331.13 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $1,258.93 | Professional | None | $194.98 | $269.15 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $138.04 | Professional | None | $33.11 | $33.11 | $138.04 |
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 $194.98 Median $251.19 Typical High $354.81 | Professional | None | $194.98 | $251.19 | $354.81 |
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 $87.10 Median $93.33 Typical High $112.20 | Professional | 52 · Reduced service | $87.10 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $37.15 Typical High $45.71 | Professional | 53 · Discontinued | $34.67 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $128.82 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $25.70 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.62 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.38 | $18.62 | $22.91 |
Where Kentucky sits
The same service costs 5.1 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· 44th of 51
$209
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.