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 $489.78 Median $575.44 Typical High $5,248.07 | Facility | None | $489.78 | $575.44 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $741.31 | Professional | None | $489.78 | $524.81 | $741.31 |
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 $467.74 Median $630.96 Typical High $954.99 | Professional | None | $467.74 | $630.96 | $954.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $389.05 Typical High $602.56 | Professional | 62 · Two surgeons | $295.12 | $389.05 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $100.00 Typical High $151.36 | Professional | 80 · Assistant surgeon | $74.13 | $100.00 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $87.10 Typical High $131.83 | Professional | AS · PA/NP assist | $64.57 | $87.10 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $1,258.93 | Facility | None | $524.81 | $758.58 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $870.96 | Professional | None | $549.54 | $707.95 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $912.01 Typical High $1,862.09 | Facility | None | $524.81 | $912.01 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $3,890.45 | Professional | None | $562.34 | $794.33 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $467.74 | Professional | None | $33.11 | $33.11 | $467.74 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,047.13 | Professional | None | $562.34 | $812.83 | $1,047.13 |
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 $245.47 Median $263.03 Typical High $338.84 | Professional | 52 · Reduced service | $245.47 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $134.90 | Professional | 53 · Discontinued | $97.72 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $512.86 | Professional | 54 · Surgery only | $371.54 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $102.33 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $67.61 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $67.61 |
Where Kentucky sits
The same service costs 4.9 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
$631
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.