How much rates vary
Facilitymedian $1,862 · 10th to 90th $832 to $8,128Professionalmedian $1,445 · 10th to 90th $1,148 to $2,239
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 $891.25 Median $1,445.44 Typical High $8,511.38 | Facility | None | $891.25 | $1,445.44 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,348.96 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,148.15 | $1,380.38 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $870.96 Typical High $1,122.02 | Professional | 62 · Two surgeons | $724.44 | $870.96 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $223.87 Typical High $288.40 | Professional | 80 · Assistant surgeon | $181.97 | $223.87 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $194.98 Typical High $251.19 | Professional | AS · PA/NP assist | $158.49 | $194.98 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,818.38 | Facility | None | $1,258.93 | $1,698.24 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,659.59 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,137.96 Typical High $3,630.78 | Facility | None | $34.67 | $2,137.96 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $12,022.64 | Professional | None | $1,318.26 | $1,778.28 | $12,022.64 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $630.96 | Professional | None | $33.11 | $33.11 | $630.96 |
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 $1,778.28 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,778.28 | $2,454.71 |
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 $588.84 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $588.84 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $269.15 Typical High $309.03 | Professional | 53 · Discontinued | $234.42 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,000.00 Typical High $1,148.15 | Professional | 54 · Surgery only | $891.25 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $177.83 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $134.90 Typical High $154.88 | Professional | 56 · Pre-op care only | $117.49 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $933.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $831.76 | $933.25 | $1,071.52 |
Where Kentucky sits
The same service costs 9.1 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· 42nd of 51
$1,445
AK $5,623TX $617
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.