How much rates vary
Facilitymedian $2,951 · 10th to 90th $794 to $8,511Professionalmedian $2,884 · 10th to 90th $2,239 to $4,467
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 $2,951.21 Typical High $8,511.38 | Facility | None | $851.14 | $2,951.21 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,691.53 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,884.03 Typical High $4,168.69 | Professional | None | $2,238.72 | $2,884.03 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $457.09 Typical High $660.69 | Professional | 80 · Assistant surgeon | $363.08 | $457.09 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $407.38 Typical High $575.44 | Professional | AS · PA/NP assist | $316.23 | $407.38 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $4,168.69 | Facility | None | $2,187.76 | $2,630.27 | $4,168.69 |
CareSource Setting Professional Modifier None Typical Low $2,818.38 Median $3,467.37 Typical High $4,265.80 | Professional | None | $2,818.38 | $3,467.37 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $4,265.80 Typical High $4,570.88 | Facility | None | $34.67 | $4,265.80 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,467.37 Typical High $18,620.87 | Professional | None | $2,630.27 | $3,467.37 | $18,620.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,819.70 | Professional | None | $33.11 | $33.11 | $1,819.70 |
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 $2,754.23 Median $3,235.94 Typical High $5,011.87 | Professional | None | $2,754.23 | $3,235.94 | $5,011.87 |
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 $1,174.90 Median $1,348.96 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,174.90 | $1,348.96 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $537.03 Typical High $707.95 | Professional | 53 · Discontinued | $478.63 | $537.03 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,041.74 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,778.28 | $2,041.74 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $407.38 Typical High $537.03 | Professional | 55 · Aftercare only | $354.81 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $269.15 Typical High $354.81 | Professional | 56 · Pre-op care only | $239.88 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,905.46 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,905.46 | $2,454.71 |
Where Kentucky sits
The same service costs 20.9 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
$2,884
AK $11,220TX $537
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.