How much rates vary
Facilitymedian $1,862 · 10th to 90th $832 to $8,511Professionalmedian $1,585 · 10th to 90th $1,202 to $2,399
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 $1,737.80 Typical High $8,511.38 | Facility | None | $891.25 | $1,737.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $1,862.09 | Professional | None | $1,513.56 | $1,737.80 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,479.11 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $933.25 Typical High $1,288.25 | Professional | 62 · Two surgeons | $758.58 | $933.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $323.59 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $281.84 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,630.27 | Facility | None | $1,380.38 | $1,659.59 | $2,630.27 |
CareSource Setting Professional Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $2,630.27 | Professional | None | $1,584.89 | $2,137.96 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $3,090.30 Typical High $4,466.84 | Facility | None | $34.67 | $3,090.30 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $9,120.11 | Professional | None | $1,584.89 | $1,995.26 | $9,120.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $776.25 | Professional | None | $33.11 | $33.11 | $776.25 |
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 $1,380.38 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,737.80 | $2,951.21 |
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 $741.31 Median $870.96 Typical High $933.25 | Professional | 52 · Reduced service | $741.31 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $346.74 Typical High $371.54 | Professional | 53 · Discontinued | $302.00 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,288.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,288.25 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $257.04 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $173.78 Typical High $186.21 | Professional | 56 · Pre-op care only | $151.36 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,202.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,202.26 | $1,318.26 |
Where Kentucky sits
The same service costs 11.2 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· 46th of 51
$1,585
AK $7,244TX $646
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.