How much rates vary
Facilitymedian $2,344 · 10th to 90th $794 to $8,128Professionalmedian $2,089 · 10th to 90th $1,622 to $3,090
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 $1,862.09 Median $1,995.26 Typical High $2,344.23 | Facility | None | $1,862.09 | $1,995.26 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,344.23 | Professional | None | $1,862.09 | $2,089.30 | $2,344.23 |
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 $1,621.81 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,621.81 | $1,949.84 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,230.27 Typical High $1,659.59 | Professional | 62 · Two surgeons | $1,023.29 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $309.03 Typical High $426.58 | Professional | 80 · Assistant surgeon | $257.04 | $309.03 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $275.42 Typical High $371.54 | Professional | AS · PA/NP assist | $223.87 | $275.42 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $3,311.31 | Facility | None | $1,737.80 | $2,089.30 | $3,311.31 |
CareSource Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,754.23 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $3,467.37 Typical High $3,630.78 | Facility | None | $34.67 | $3,467.37 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,691.53 Typical High $10,471.29 | Professional | None | $2,041.74 | $2,691.53 | $10,471.29 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,380.38 | Professional | None | $33.11 | $33.11 | $1,380.38 |
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 $1,905.46 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,905.46 | $2,238.72 | $3,801.89 |
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 $933.25 Median $1,047.13 Typical High $1,174.90 | Professional | 52 · Reduced service | $933.25 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $416.87 Typical High $467.74 | Professional | 53 · Discontinued | $380.19 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,548.82 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,412.54 | $1,548.82 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $309.03 Typical High $346.74 | Professional | 55 · Aftercare only | $281.84 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $208.93 Typical High $234.42 | Professional | 56 · Pre-op care only | $186.21 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,445.44 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,445.44 | $1,621.81 |
Where Kentucky sits
The same service costs 21.4 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· 45th of 51
$2,089
AK $9,120TX $427
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.