How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,047 to $12,023Professionalmedian $1,413 · 10th to 90th $1,047 to $2,291
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 $977.24 Median $1,096.48 Typical High $3,630.78 | Facility | None | $977.24 | $1,096.48 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,862.09 | Professional | None | $977.24 | $1,096.48 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $12,022.64 | Facility | None | $1,202.26 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,445.44 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,137.96 Typical High $2,884.03 | Professional | 50 · Both sides | $1,778.28 | $2,137.96 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $891.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $741.31 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $229.09 Typical High $309.03 | Professional | 80 · Assistant surgeon | $190.55 | $229.09 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $199.53 Typical High $269.15 | Professional | AS · PA/NP assist | $165.96 | $199.53 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $8,912.51 | Facility | None | $1,047.13 | $1,479.11 | $8,912.51 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,174.90 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $5,495.41 | Facility | None | $1,862.09 | $2,511.89 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,949.84 Typical High $7,762.47 | Professional | None | $1,071.52 | $1,949.84 | $7,762.47 |
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 $977.24 Median $1,862.09 Typical High $8,912.51 | Facility | None | $977.24 | $1,862.09 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,412.54 | $2,691.53 |
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 $478.63 Median $501.19 Typical High $645.65 | Professional | 52 · Reduced service | $478.63 | $501.19 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $257.04 | Professional | 53 · Discontinued | $194.98 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $977.24 | Professional | 54 · Surgery only | $724.44 | $758.58 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $194.98 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $128.82 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $912.01 |
Where Kentucky sits
The same service costs 6.3 times more in Wyoming than in Hawaii. 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.
Physician feeFacility fee
WY $21,505HI $3,422
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.