How much rates vary
Facilitymedian $1,445 · 10th to 90th $794 to $8,511Professionalmedian $1,230 · 10th to 90th $955 to $1,905
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 $1,348.96 Typical High $8,511.38 | Facility | None | $891.25 | $1,348.96 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,230.27 | $1,445.44 |
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 $933.25 Median $1,202.26 Typical High $1,659.59 | Professional | None | $933.25 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,819.70 Typical High $2,511.89 | Professional | 50 · Both sides | $1,412.54 | $1,819.70 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $776.25 Typical High $1,071.52 | Professional | 62 · Two surgeons | $588.84 | $776.25 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $199.53 Typical High $269.15 | Professional | 80 · Assistant surgeon | $151.36 | $199.53 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $173.78 Typical High $234.42 | Professional | AS · PA/NP assist | $131.83 | $173.78 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,862.09 | Facility | None | $1,000.00 | $1,202.26 | $1,862.09 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,584.89 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,995.26 Typical High $4,570.88 | Facility | None | $34.67 | $1,995.26 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $7,585.78 | Professional | None | $1,202.26 | $1,513.56 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $676.08 | Professional | None | $33.11 | $33.11 | $676.08 |
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 $1,148.15 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,445.44 | $2,238.72 |
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 $537.03 Median $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $537.03 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $245.47 Typical High $288.40 | Professional | 53 · Discontinued | $213.80 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $1,096.48 | Professional | 54 · Surgery only | $812.83 | $912.01 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $162.18 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $123.03 Typical High $144.54 | Professional | 56 · Pre-op care only | $107.15 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $1,023.29 |
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· 43rd of 51
$1,259
AK $5,129TX $288
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.