How much rates vary
Facilitymedian $1,660 · 10th to 90th $525 to $4,169Professionalmedian $2,570 · 10th to 90th $2,138 to $3,802
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 $851.14 Median $2,570.40 Typical High $8,511.38 | Facility | None | $851.14 | $2,570.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $2,691.53 | Professional | None | $2,290.87 | $2,454.71 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,995.26 | $2,511.89 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,584.89 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,258.93 | $1,584.89 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $407.38 Typical High $562.34 | Professional | 80 · Assistant surgeon | $323.59 | $407.38 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $354.81 Typical High $489.78 | Professional | AS · PA/NP assist | $281.84 | $354.81 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $2,398.83 Typical High $2,818.38 | Facility | None | $1,348.96 | $2,398.83 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $2,454.71 Median $3,467.37 Typical High $4,073.80 | Professional | None | $2,454.71 | $3,467.37 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,288.25 Typical High $4,168.69 | Facility | None | $34.67 | $1,288.25 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $14,791.08 | Professional | None | $2,344.23 | $3,019.95 | $14,791.08 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $4,677.35 | Professional | None | $2,187.76 | $2,691.53 | $4,677.35 |
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 $1,148.15 Median $1,230.27 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,148.15 | $1,230.27 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $489.78 Typical High $537.03 | Professional | 53 · Discontinued | $457.09 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,819.70 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,698.24 | $1,819.70 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $371.54 Typical High $407.38 | Professional | 55 · Aftercare only | $338.84 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $245.47 Typical High $269.15 | Professional | 56 · Pre-op care only | $229.09 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,698.24 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,698.24 | $1,905.46 |
Where Kentucky sits
The same service costs 15.8 times more in Alaska than in Texas. 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
$2,512
AK $8,128TX $513
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.