How much rates vary
Facilitymedian $1,778 · 10th to 90th $832 to $8,511Professionalmedian $1,585 · 10th to 90th $1,318 to $2,455
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 $1,000.00 Median $1,737.80 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,737.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,621.81 | $1,778.28 |
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 $1,318.26 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,548.82 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,000.00 Typical High $1,348.96 | Professional | 62 · Two surgeons | $831.76 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $257.04 Typical High $338.84 | Professional | 80 · Assistant surgeon | $208.93 | $257.04 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $223.87 Typical High $295.12 | Professional | AS · PA/NP assist | $181.97 | $223.87 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,454.71 | Facility | None | $1,318.26 | $1,548.82 | $2,454.71 |
CareSource Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,698.24 | $2,089.30 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,818.38 Typical High $8,128.31 | Facility | None | $34.67 | $2,818.38 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $9,332.54 | Professional | None | $1,584.89 | $1,905.46 | $9,332.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $851.14 | Professional | None | $33.11 | $33.11 | $851.14 |
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 $1,479.11 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,862.09 | $2,884.03 |
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 $707.95 Median $812.83 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $323.59 Typical High $354.81 | Professional | 53 · Discontinued | $281.84 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,230.27 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,047.13 | $1,230.27 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $245.47 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $162.18 Typical High $177.83 | Professional | 56 · Pre-op care only | $141.25 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,148.15 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $977.24 | $1,148.15 | $1,230.27 |
Where Kentucky sits
The same service costs 5.3 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 $17,981KY $3,363
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.