How much rates vary
Facilitymedian $1,862 · 10th to 90th $832 to $8,913Professionalmedian $2,239 · 10th to 90th $1,738 to $3,890
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 $1,737.80 Median $2,137.96 Typical High $3,548.13 | Facility | None | $1,737.80 | $2,137.96 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,737.80 | $1,995.26 | $2,570.40 |
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 $1,737.80 Median $2,238.72 Typical High $3,890.45 | Professional | None | $1,737.80 | $2,238.72 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,380.38 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,096.48 | $1,380.38 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $354.81 Typical High $616.60 | Professional | 80 · Assistant surgeon | $275.42 | $354.81 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $309.03 Typical High $549.54 | Professional | AS · PA/NP assist | $245.47 | $309.03 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $3,019.95 | Facility | None | $1,621.81 | $1,949.84 | $3,019.95 |
CareSource Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $3,090.30 | Professional | None | $1,905.46 | $2,454.71 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,258.93 Typical High $3,235.94 | Facility | None | $34.67 | $1,258.93 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,818.38 Typical High $18,620.87 | Professional | None | $1,949.84 | $2,818.38 | $18,620.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,348.96 | Professional | None | $33.11 | $33.11 | $1,348.96 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,715.35 | Professional | None | $2,137.96 | $2,511.89 | $3,715.35 |
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 $870.96 Median $1,000.00 Typical High $1,288.25 | Professional | 52 · Reduced service | $870.96 | $1,000.00 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $398.11 Typical High $512.86 | Professional | 53 · Discontinued | $346.74 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,479.11 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,318.26 | $1,479.11 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $295.12 Typical High $380.19 | Professional | 55 · Aftercare only | $263.03 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $199.53 Typical High $257.04 | Professional | 56 · Pre-op care only | $173.78 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,380.38 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,380.38 | $1,778.28 |
Where Kentucky sits
The same service costs 19.5 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
$2,239
AK $8,318TX $427
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.