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 $794.33 Median $1,096.48 Typical High $5,248.07 | Facility | None | $794.33 | $1,096.48 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,230.27 | Professional | None | $933.25 | $1,000.00 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,513.56 | Professional | None | $933.25 | $1,122.02 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $181.97 Typical High $245.47 | Professional | 80 · Assistant surgeon | $147.91 | $181.97 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $158.49 Typical High $213.80 | Professional | AS · PA/NP assist | $131.83 | $158.49 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,659.59 Typical High $5,248.07 | Facility | None | $870.96 | $1,659.59 | $5,248.07 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,348.96 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,630.27 | Facility | None | $1,584.89 | $1,862.09 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $6,456.54 | Professional | None | $1,047.13 | $1,380.38 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $676.08 | Professional | None | $33.11 | $33.11 | $676.08 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,445.44 | $1,905.46 |
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 $467.74 Median $501.19 Typical High $616.60 | Professional | 52 · Reduced service | $467.74 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $245.47 | Professional | 53 · Discontinued | $186.21 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $912.01 | Professional | 54 · Surgery only | $691.83 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $151.36 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $123.03 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $851.14 |
Where Kentucky sits
The same service costs 6.2 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· 42nd of 51
$1,148
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.