How much rates vary
Facilitymedian $1,905 · 10th to 90th $794 to $8,511Professionalmedian $1,413 · 10th to 90th $1,175 to $2,188
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 $1,479.11 Typical High $8,511.38 | Facility | None | $851.14 | $1,479.11 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,348.96 | $1,479.11 |
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 $1,174.90 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,380.38 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $295.12 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $194.98 Typical High $251.19 | Professional | AS · PA/NP assist | $165.96 | $194.98 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $4,897.79 | Facility | None | $1,288.25 | $2,089.30 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,778.28 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,238.72 Typical High $4,570.88 | Facility | None | $34.67 | $2,238.72 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $7,762.47 | Professional | None | $1,318.26 | $1,737.80 | $7,762.47 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $758.58 | Professional | None | $33.11 | $33.11 | $758.58 |
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 $1,348.96 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,659.59 | $2,511.89 |
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 $602.56 Median $676.08 Typical High $741.31 | Professional | 52 · Reduced service | $602.56 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $269.15 Typical High $295.12 | Professional | 53 · Discontinued | $239.88 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,023.29 Typical High $1,122.02 | Professional | 54 · Surgery only | $891.25 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $204.17 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $134.90 Typical High $147.91 | Professional | 56 · Pre-op care only | $120.23 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $954.99 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $831.76 | $954.99 | $1,047.13 |
Where Kentucky sits
The same service costs 19.5 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
$1,413
AK $5,754TX $295
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.