How much rates vary
Facilitymedian $1,905 · 10th to 90th $794 to $8,913Professionalmedian $1,698 · 10th to 90th $1,380 to $2,570
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 $1,698.24 Typical High $8,511.38 | Facility | None | $851.14 | $1,698.24 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,584.89 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $8,912.51 Typical High $11,220.18 | Facility | None | $1,000.00 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,380.38 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $263.03 Typical High $363.08 | Professional | 80 · Assistant surgeon | $218.78 | $263.03 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $234.42 Typical High $316.23 | Professional | AS · PA/NP assist | $190.55 | $234.42 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $2,398.83 Typical High $6,309.57 | Facility | None | $1,288.25 | $2,398.83 | $6,309.57 |
CareSource Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,513.56 | $1,949.84 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,511.89 Typical High $4,570.88 | Facility | None | $34.67 | $2,511.89 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $10,000.00 | Professional | None | $1,548.82 | $1,995.26 | $10,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $977.24 | Professional | None | $33.11 | $33.11 | $977.24 |
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 $1,584.89 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,584.89 | $1,949.84 | $2,951.21 |
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 $691.83 Median $794.33 Typical High $954.99 | Professional | 52 · Reduced service | $691.83 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $316.23 Typical High $380.19 | Professional | 53 · Discontinued | $275.42 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,202.26 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,047.13 | $1,202.26 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $281.84 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $190.55 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,122.02 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,122.02 | $1,318.26 |
Where Kentucky sits
The same service costs 20.4 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· 40th of 51
$1,698
AK $6,607TX $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.