How much rates vary
Facilitymedian $2,512 · 10th to 90th $646 to $10,000Professionalmedian $676 · 10th to 90th $437 to $1,096
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 $501.19 Median $645.65 Typical High $1,380.38 | Facility | None | $501.19 | $645.65 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $794.33 | Professional | None | $501.19 | $645.65 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $794.33 | Professional | None | $436.52 | $537.03 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $85.11 Typical High $128.82 | Professional | 80 · Assistant surgeon | $70.79 | $85.11 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $74.13 Typical High $112.20 | Professional | AS · PA/NP assist | $61.66 | $74.13 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $870.96 Typical High $4,897.79 | Facility | None | $549.54 | $870.96 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $891.25 | Professional | None | $602.56 | $741.31 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,511.89 Typical High $3,630.78 | Facility | None | $954.99 | $2,511.89 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $3,890.45 | Professional | None | $562.34 | $794.33 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $257.04 | Professional | None | $33.11 | $33.11 | $257.04 |
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 $616.60 Median $812.83 Typical High $1,174.90 | Professional | None | $616.60 | $812.83 | $1,174.90 |
12 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 Facility Modifier 52 · Reduced service Typical Low $251.19 Median $323.59 Typical High $398.11 | Facility | 52 · Reduced service | $251.19 | $323.59 | $398.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $100.00 Median $128.82 Typical High $162.18 | Facility | 53 · Discontinued | $100.00 | $128.82 | $162.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $380.19 Median $489.78 Typical High $602.56 | Facility | 54 · Surgery only | $380.19 | $489.78 | $602.56 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $75.86 Median $97.72 Typical High $120.23 | Facility | 55 · Aftercare only | $75.86 | $97.72 | $120.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $79.43 | Facility | 56 · Pre-op care only | $50.12 | $64.57 | $79.43 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $457.09 Typical High $562.34 | Facility | 78 · Unplanned return to OR | $354.81 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $323.59 Typical High $398.11 | Professional | 52 · Reduced service | $251.19 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $128.82 Typical High $162.18 | Professional | 53 · Discontinued | $100.00 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $489.78 Typical High $602.56 | Professional | 54 · Surgery only | $380.19 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $97.72 Typical High $120.23 | Professional | 55 · Aftercare only | $75.86 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $79.43 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $457.09 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $354.81 | $457.09 | $562.34 |
Where Kentucky sits
The same service costs 6.2 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· 46th of 51
$692
AK $3,020TX $490
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.