How much rates vary
Facilitymedian $1,778 · 10th to 90th $724 to $4,365Professionalmedian $871 · 10th to 90th $724 to $1,318
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 $724.44 Median $912.01 Typical High $8,511.38 | Facility | None | $724.44 | $912.01 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $912.01 | Professional | None | $724.44 | $831.76 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,122.02 | Professional | None | $724.44 | $851.14 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $537.03 Typical High $707.95 | Professional | 62 · Two surgeons | $457.09 | $537.03 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $177.83 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $120.23 Typical High $158.49 | Professional | AS · PA/NP assist | $100.00 | $120.23 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $1,258.93 Typical High $4,897.79 | Facility | None | $776.25 | $1,258.93 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,318.26 | Professional | None | $724.44 | $1,071.52 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $3,630.78 | Facility | None | $1,348.96 | $1,659.59 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $4,786.30 | Professional | None | $812.83 | $1,047.13 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $478.63 | Professional | None | $33.11 | $33.11 | $478.63 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,548.82 | Professional | None | $812.83 | $1,023.29 | $1,548.82 |
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 $363.08 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $549.54 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $512.86 | $588.84 | $645.65 |
Where Kentucky sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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
AK $10,228KY $2,649
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.