How much rates vary
Facilitymedian $1,318 · 10th to 90th $676 to $8,511Professionalmedian $776 · 10th to 90th $631 to $1,202
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 $676.08 Median $831.76 Typical High $5,495.41 | Facility | None | $676.08 | $831.76 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,023.29 | Professional | None | $676.08 | $776.25 | $1,023.29 |
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 $630.96 Median $758.58 Typical High $1,071.52 | Professional | None | $630.96 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,148.15 Typical High $1,621.81 | Professional | 50 · Both sides | $933.25 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $478.63 Typical High $676.08 | Professional | 62 · Two surgeons | $389.05 | $478.63 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $120.23 Typical High $169.82 | Professional | 80 · Assistant surgeon | $100.00 | $120.23 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $107.15 Typical High $151.36 | Professional | AS · PA/NP assist | $87.10 | $107.15 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $4,897.79 | Facility | None | $724.44 | $1,174.90 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,202.26 | Professional | None | $794.33 | $977.24 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,230.27 Typical High $3,630.78 | Facility | None | $34.67 | $1,230.27 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $4,466.84 | Professional | None | $758.58 | $954.99 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $489.78 | Professional | None | $33.11 | $33.11 | $489.78 |
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 $724.44 Median $912.01 Typical High $1,412.54 | Professional | None | $724.44 | $912.01 | $1,412.54 |
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 $338.84 Median $389.05 Typical High $426.58 | Professional | 52 · Reduced service | $338.84 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $154.88 Typical High $169.82 | Professional | 53 · Discontinued | $134.90 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $501.19 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $100.00 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $77.62 Typical High $85.11 | Professional | 56 · Pre-op care only | $67.61 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $537.03 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $467.74 | $537.03 | $588.84 |
Where Kentucky sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $10,315KY $2,095
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.