How much rates vary
Facilitymedian $2,630 · 10th to 90th $832 to $9,333Professionalmedian $2,344 · 10th to 90th $1,950 to $3,631
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 $2,570.40 Typical High $8,511.38 | Facility | None | $891.25 | $2,570.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,089.30 | $2,398.83 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,332.54 Typical High $11,220.18 | Facility | None | $758.58 | $9,332.54 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,949.84 | $2,290.87 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,445.44 Typical High $1,949.84 | Professional | 62 · Two surgeons | $1,230.27 | $1,445.44 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $371.54 Typical High $512.86 | Professional | 80 · Assistant surgeon | $309.03 | $371.54 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $323.59 Typical High $446.68 | Professional | AS · PA/NP assist | $275.42 | $323.59 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $3,630.78 | Facility | None | $1,949.84 | $2,344.23 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $2,238.72 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,238.72 | $3,090.30 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $3,981.07 Typical High $4,466.84 | Facility | None | $34.67 | $3,981.07 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $10,964.78 | Professional | None | $2,344.23 | $2,884.03 | $10,964.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,412.54 | Professional | None | $33.11 | $33.11 | $1,412.54 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $4,265.80 | Professional | None | $2,290.87 | $2,754.23 | $4,265.80 |
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 $1,047.13 Median $1,202.26 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,047.13 | $1,202.26 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $478.63 Typical High $524.81 | Professional | 53 · Discontinued | $416.87 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,819.70 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,584.89 | $1,819.70 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $363.08 Typical High $389.05 | Professional | 55 · Aftercare only | $316.23 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $239.88 Typical High $257.04 | Professional | 56 · Pre-op care only | $208.93 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,698.24 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,698.24 | $1,819.70 |
Where Kentucky sits
The same service costs 4.0 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.
Physician feeFacility fee
AK $19,772TX $4,915
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.