How much rates vary
Facilitymedian $1,380 · 10th to 90th $794 to $8,128Professionalmedian $1,202 · 10th to 90th $955 to $1,820
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 $1,047.13 Median $1,288.25 Typical High $1,348.96 | Facility | None | $1,047.13 | $1,288.25 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,202.26 | $1,348.96 |
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 $954.99 Median $1,148.15 Typical High $1,698.24 | Professional | None | $954.99 | $1,148.15 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,737.80 Typical High $2,570.40 | Professional | 50 · Both sides | $1,445.44 | $1,737.80 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $724.44 Typical High $1,071.52 | Professional | 62 · Two surgeons | $602.56 | $724.44 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $186.21 Typical High $269.15 | Professional | 80 · Assistant surgeon | $151.36 | $186.21 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $162.18 Typical High $239.88 | Professional | AS · PA/NP assist | $134.90 | $162.18 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,819.70 | Facility | None | $977.24 | $1,174.90 | $1,819.70 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,548.82 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,949.84 Typical High $4,677.35 | Facility | None | $34.67 | $1,949.84 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $7,079.46 | Professional | None | $1,174.90 | $1,479.11 | $7,079.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $776.25 | Professional | None | $33.11 | $33.11 | $776.25 |
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 $1,096.48 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,380.38 | $2,187.76 |
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 $524.81 Median $602.56 Typical High $676.08 | Professional | 52 · Reduced service | $524.81 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $239.88 Typical High $269.15 | Professional | 53 · Discontinued | $208.93 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $891.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $794.33 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $158.49 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $120.23 Typical High $134.90 | Professional | 56 · Pre-op care only | $104.71 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $831.76 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $741.31 | $831.76 | $933.25 |
Where Kentucky sits
The same service costs 16.2 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· 43rd of 51
$1,202
AK $5,012TX $309
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.