How much rates vary
Facilitymedian $4,169 · 10th to 90th $871 to $15,136Professionalmedian $4,074 · 10th to 90th $3,311 to $6,310
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 $3,311.31 Median $4,168.69 Typical High $5,370.32 | Facility | None | $3,311.31 | $4,168.69 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $3,311.31 Median $3,801.89 Typical High $4,897.79 | Professional | None | $3,311.31 | $3,801.89 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,332.54 Typical High $11,220.18 | Facility | None | $758.58 | $9,332.54 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,311.31 Median $4,073.80 Typical High $6,165.95 | Professional | None | $3,311.31 | $4,073.80 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,897.79 Median $6,025.60 Typical High $9,332.54 | Professional | 50 · Both sides | $4,897.79 | $6,025.60 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,089.30 Median $2,511.89 Typical High $3,890.45 | Professional | 62 · Two surgeons | $2,089.30 | $2,511.89 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $645.65 Typical High $977.24 | Professional | 80 · Assistant surgeon | $524.81 | $645.65 | $977.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $562.34 Typical High $870.96 | Professional | AS · PA/NP assist | $457.09 | $562.34 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $3,090.30 Median $3,715.35 Typical High $5,754.40 | Facility | None | $3,090.30 | $3,715.35 | $5,754.40 |
CareSource Setting Professional Modifier None Typical Low $3,311.31 Median $4,897.79 Typical High $6,025.60 | Professional | None | $3,311.31 | $4,897.79 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $6,165.95 Typical High $16,595.87 | Facility | None | $34.67 | $6,165.95 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $5,128.61 Typical High $28,183.83 | Professional | None | $3,715.35 | $5,128.61 | $28,183.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $2,754.23 | Professional | None | $33.11 | $33.11 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,162.28 Typical High $12,302.69 | Facility | None | $1,148.15 | $3,162.28 | $12,302.69 |
United Setting Professional Modifier None Typical Low $3,890.45 Median $4,786.30 Typical High $7,079.46 | Professional | None | $3,890.45 | $4,786.30 | $7,079.46 |
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 $1,659.59 Median $1,905.46 Typical High $2,454.71 | Professional | 52 · Reduced service | $1,659.59 | $1,905.46 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $758.58 Typical High $977.24 | Professional | 53 · Discontinued | $660.69 | $758.58 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,884.03 Typical High $3,630.78 | Professional | 54 · Surgery only | $2,511.89 | $2,884.03 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $575.44 Typical High $724.44 | Professional | 55 · Aftercare only | $501.19 | $575.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $380.19 Typical High $489.78 | Professional | 56 · Pre-op care only | $331.13 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,691.53 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,691.53 | $3,388.44 |
Where Kentucky sits
The same service costs 20.4 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· 41st of 51
$4,074
AK $15,849TX $776
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.