How much rates vary
Facilitymedian $2,692 · 10th to 90th $562 to $10,715Professionalmedian $631 · 10th to 90th $490 to $1,023
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 $446.68 Median $562.34 Typical High $1,230.27 | Facility | None | $446.68 | $562.34 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $691.83 | Professional | None | $446.68 | $549.54 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,584.89 | $4,677.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $831.76 | Professional | None | $489.78 | $588.84 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $93.33 Typical High $134.90 | Professional | 80 · Assistant surgeon | $77.62 | $93.33 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $83.18 Typical High $117.49 | Professional | AS · PA/NP assist | $67.61 | $83.18 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $776.25 Typical High $3,630.78 | Facility | None | $489.78 | $776.25 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $812.83 | Professional | None | $489.78 | $660.69 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,454.71 Typical High $3,090.30 | Facility | None | $851.14 | $2,454.71 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $741.31 Typical High $3,630.78 | Professional | None | $501.19 | $741.31 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $302.00 | Professional | None | $33.11 | $33.11 | $302.00 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,122.02 | Professional | None | $602.56 | $758.58 | $1,122.02 |
12 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 Facility Modifier 52 · Reduced service Typical Low $223.87 Median $281.84 Typical High $338.84 | Facility | 52 · Reduced service | $223.87 | $281.84 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $91.20 Median $112.20 Typical High $138.04 | Facility | 53 · Discontinued | $91.20 | $112.20 | $138.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $338.84 Median $416.87 Typical High $512.86 | Facility | 54 · Surgery only | $338.84 | $416.87 | $512.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $67.61 Median $83.18 Typical High $102.33 | Facility | 55 · Aftercare only | $67.61 | $83.18 | $102.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $44.67 Median $56.23 Typical High $69.18 | Facility | 56 · Pre-op care only | $44.67 | $56.23 | $69.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $389.05 Typical High $478.63 | Facility | 78 · Unplanned return to OR | $316.23 | $389.05 | $478.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $263.03 Typical High $331.13 | Professional | 52 · Reduced service | $223.87 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $107.15 Typical High $131.83 | Professional | 53 · Discontinued | $91.20 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $398.11 Typical High $489.78 | Professional | 54 · Surgery only | $338.84 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $97.72 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $66.07 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $371.54 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $316.23 | $371.54 | $457.09 |
Where Kentucky sits
The same service costs 6.2 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· 39th of 51
$661
AK $2,570TX $417
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.