How much rates vary
Facilitymedian $1,950 · 10th to 90th $794 to $10,471Professionalmedian $1,349 · 10th to 90th $1,096 to $2,089
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 $1,318.26 Typical High $3,235.94 | Facility | None | $851.14 | $1,318.26 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,258.93 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $11,220.18 Typical High $27,542.29 | Facility | None | $758.58 | $11,220.18 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,348.96 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $851.14 Typical High $1,122.02 | Professional | 62 · Two surgeons | $691.83 | $851.14 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $213.80 Typical High $281.84 | Professional | 80 · Assistant surgeon | $177.83 | $213.80 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $186.21 Typical High $245.47 | Professional | AS · PA/NP assist | $154.88 | $186.21 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,949.84 | Facility | None | $1,023.29 | $1,230.27 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,659.59 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,089.30 Typical High $3,630.78 | Facility | None | $34.67 | $2,089.30 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $6,918.31 | Professional | None | $1,230.27 | $1,621.81 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $724.44 | Professional | None | $33.11 | $33.11 | $724.44 |
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 $1,258.93 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,548.82 | $2,398.83 |
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 $562.34 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $562.34 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $257.04 Typical High $275.42 | Professional | 53 · Discontinued | $223.87 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $954.99 Typical High $1,047.13 | Professional | 54 · Surgery only | $831.76 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $169.82 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $891.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $776.25 | $891.25 | $977.24 |
Where Kentucky sits
The same service costs 15.1 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· 43rd of 51
$1,349
AK $5,370TX $355
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.