How much rates vary
Facilitymedian $1,995 · 10th to 90th $794 to $10,471Professionalmedian $1,318 · 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 $1,412.54 Typical High $3,235.94 | Facility | None | $851.14 | $1,412.54 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,318.26 | $1,479.11 |
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 $1,288.25 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,288.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $831.76 Typical High $1,174.90 | Professional | 62 · Two surgeons | $691.83 | $831.76 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $295.12 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $186.21 Typical High $257.04 | Professional | AS · PA/NP assist | $151.36 | $186.21 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,995.26 | Facility | None | $1,071.52 | $1,288.25 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,621.81 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,187.76 Typical High $4,677.35 | Facility | None | $34.67 | $2,187.76 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $7,762.47 | Professional | None | $1,288.25 | $1,659.59 | $7,762.47 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $741.31 | Professional | None | $33.11 | $33.11 | $741.31 |
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 $2,454.71 | Professional | None | $1,258.93 | $1,548.82 | $2,454.71 |
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 $575.44 Median $645.65 Typical High $741.31 | Professional | 52 · Reduced service | $575.44 | $645.65 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $263.03 Typical High $295.12 | Professional | 53 · Discontinued | $229.09 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $1,096.48 | Professional | 54 · Surgery only | $870.96 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $218.78 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $131.83 Typical High $147.91 | Professional | 56 · Pre-op care only | $114.82 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $1,023.29 |
Where Kentucky sits
The same service costs 17.0 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· 44th of 51
$1,349
AK $5,495TX $324
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.