How much rates vary
Facilitymedian $1,380 · 10th to 90th $794 to $8,913Professionalmedian $1,148 · 10th to 90th $912 to $1,778
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 $1,148.15 Typical High $8,511.38 | Facility | None | $891.25 | $1,148.15 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,288.25 | Professional | None | $933.25 | $1,071.52 | $1,288.25 |
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 $912.01 Median $1,122.02 Typical High $1,548.82 | Professional | None | $912.01 | $1,122.02 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $707.95 Typical High $954.99 | Professional | 62 · Two surgeons | $575.44 | $707.95 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $177.83 Typical High $245.47 | Professional | 80 · Assistant surgeon | $144.54 | $177.83 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $158.49 Typical High $213.80 | Professional | AS · PA/NP assist | $125.89 | $158.49 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,621.81 | Facility | None | $851.14 | $1,023.29 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,348.96 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,659.59 Typical High $4,570.88 | Facility | None | $34.67 | $1,659.59 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $6,760.83 | Professional | None | $1,047.13 | $1,380.38 | $6,760.83 |
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 $1,071.52 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,318.26 | $1,949.84 |
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 $467.74 Median $524.81 Typical High $645.65 | Professional | 52 · Reduced service | $467.74 | $524.81 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $213.80 Typical High $257.04 | Professional | 53 · Discontinued | $186.21 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $794.33 Typical High $977.24 | Professional | 54 · Surgery only | $691.83 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $158.49 Typical High $194.98 | Professional | 55 · Aftercare only | $138.04 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $107.15 Typical High $128.82 | Professional | 56 · Pre-op care only | $93.33 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $741.31 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $645.65 | $741.31 | $912.01 |
Where Kentucky sits
The same service costs 17.8 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· 41st of 51
$1,148
AK $4,467TX $251
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.