How much rates vary
Facilitymedian $1,202 · 10th to 90th $708 to $6,310Professionalmedian $1,148 · 10th to 90th $851 to $1,738
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 $794.33 Median $1,047.13 Typical High $2,630.27 | Facility | None | $794.33 | $1,047.13 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,202.26 | Professional | None | $851.14 | $977.24 | $1,202.26 |
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 $891.25 Median $1,096.48 Typical High $1,479.11 | Professional | None | $891.25 | $1,096.48 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $724.44 Typical High $1,023.29 | Professional | 62 · Two surgeons | $588.84 | $724.44 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $177.83 Typical High $239.88 | Professional | 80 · Assistant surgeon | $144.54 | $177.83 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $154.88 Typical High $208.93 | Professional | AS · PA/NP assist | $125.89 | $154.88 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $4,897.79 | Facility | None | $912.01 | $1,479.11 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,548.82 | Professional | None | $933.25 | $1,258.93 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,584.89 Typical High $3,630.78 | Facility | None | $34.67 | $1,584.89 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $6,309.57 | Professional | None | $954.99 | $1,380.38 | $6,309.57 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $645.65 | Professional | None | $33.11 | $33.11 | $645.65 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,318.26 | $1,995.26 |
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 $426.58 Median $489.78 Typical High $588.84 | Professional | 52 · Reduced service | $426.58 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $194.98 Typical High $239.88 | Professional | 53 · Discontinued | $169.82 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $891.25 | Professional | 54 · Surgery only | $645.65 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $177.83 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $97.72 Typical High $120.23 | Professional | 56 · Pre-op care only | $85.11 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $831.76 |
Where Kentucky sits
The same service costs 7.9 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
$1,148
AK $4,074TX $513
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.