How much rates vary
Facilitymedian $2,951 · 10th to 90th $832 to $9,120Professionalmedian $2,570 · 10th to 90th $2,042 to $3,981
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 $2,951.21 Typical High $8,511.38 | Facility | None | $851.14 | $2,951.21 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,754.23 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,754.23 | $2,951.21 |
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 $2,041.74 Median $2,454.71 Typical High $3,890.45 | Professional | None | $2,041.74 | $2,454.71 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $398.11 Typical High $630.96 | Professional | 80 · Assistant surgeon | $323.59 | $398.11 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $346.74 Typical High $549.54 | Professional | AS · PA/NP assist | $288.40 | $346.74 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $2,238.72 Median $4,168.69 Typical High $5,888.44 | Facility | None | $2,238.72 | $4,168.69 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $4,365.16 | Professional | None | $2,884.03 | $3,548.13 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $4,168.69 Typical High $4,466.84 | Facility | None | $34.67 | $4,168.69 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $15,488.17 | Professional | None | $2,691.53 | $3,388.44 | $15,488.17 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,905.46 | Professional | None | $33.11 | $33.11 | $1,905.46 |
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 $2,511.89 Median $2,818.38 Typical High $4,897.79 | Professional | None | $2,511.89 | $2,818.38 | $4,897.79 |
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 $1,202.26 Median $1,380.38 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,202.26 | $1,380.38 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $549.54 Typical High $602.56 | Professional | 53 · Discontinued | $478.63 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,041.74 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,819.70 | $2,041.74 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $407.38 Typical High $446.68 | Professional | 55 · Aftercare only | $363.08 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $275.42 Typical High $295.12 | Professional | 56 · Pre-op care only | $239.88 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,905.46 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,905.46 | $2,089.30 |
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· 45th of 51
$2,570
AK $11,482TX $589
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.