How much rates vary
Facilitymedian $2,818 · 10th to 90th $832 to $9,120Professionalmedian $2,692 · 10th to 90th $2,188 to $4,169
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 $2,754.23 Typical High $8,511.38 | Facility | None | $851.14 | $2,754.23 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,570.40 | $2,818.38 |
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 $2,187.76 Median $2,630.27 Typical High $3,890.45 | Professional | None | $2,187.76 | $2,630.27 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,659.59 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,380.38 | $1,659.59 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $416.87 Typical High $616.60 | Professional | 80 · Assistant surgeon | $346.74 | $416.87 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $371.54 Typical High $549.54 | Professional | AS · PA/NP assist | $309.03 | $371.54 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,890.45 | Facility | None | $2,089.30 | $2,454.71 | $3,890.45 |
CareSource Setting Professional Modifier None Typical Low $2,187.76 Median $3,311.31 Typical High $3,981.07 | Professional | None | $2,187.76 | $3,311.31 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $4,168.69 Typical High $5,623.41 | Facility | None | $34.67 | $4,168.69 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,162.28 Typical High $16,595.87 | Professional | None | $2,511.89 | $3,162.28 | $16,595.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,479.11 | Professional | None | $33.11 | $33.11 | $1,479.11 |
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 $2,570.40 Median $3,090.30 Typical High $4,677.35 | Professional | None | $2,570.40 | $3,090.30 | $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 $1,122.02 Median $1,288.25 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,122.02 | $1,288.25 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $512.86 Typical High $630.96 | Professional | 53 · Discontinued | $446.68 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,905.46 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,659.59 | $1,905.46 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $380.19 Typical High $478.63 | Professional | 55 · Aftercare only | $338.84 | $380.19 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $257.04 Typical High $316.23 | Professional | 56 · Pre-op care only | $223.87 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,778.28 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,778.28 | $2,238.72 |
Where Kentucky sits
The same service costs 8.7 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· 42nd of 51
$2,692
AK $10,715TX $1,230
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.