How much rates vary
Facilitymedian $2,570 · 10th to 90th $871 to $11,220Professionalmedian $2,239 · 10th to 90th $1,820 to $3,467
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 $2,238.72 Typical High $7,943.28 | Facility | None | $1,000.00 | $2,238.72 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,819.70 | $2,089.30 | $2,570.40 |
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 $1,819.70 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,238.72 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,412.54 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,148.15 | $1,412.54 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $354.81 Typical High $512.86 | Professional | 80 · Assistant surgeon | $288.40 | $354.81 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $316.23 Typical High $446.68 | Professional | AS · PA/NP assist | $251.19 | $316.23 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $3,162.28 | Facility | None | $1,698.24 | $2,041.74 | $3,162.28 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $3,311.31 | Professional | None | $1,819.70 | $2,691.53 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $3,388.44 Typical High $10,964.78 | Facility | None | $34.67 | $3,388.44 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $27,542.29 | Professional | None | $2,041.74 | $2,630.27 | $27,542.29 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,380.38 | Professional | None | $33.11 | $33.11 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,162.28 Typical High $12,302.69 | Facility | None | $1,148.15 | $3,162.28 | $12,302.69 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $3,801.89 | Professional | None | $2,137.96 | $2,570.40 | $3,801.89 |
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 $912.01 Median $1,047.13 Typical High $1,258.93 | Professional | 52 · Reduced service | $912.01 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $416.87 Typical High $512.86 | Professional | 53 · Discontinued | $363.08 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,548.82 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,380.38 | $1,548.82 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $309.03 Typical High $380.19 | Professional | 55 · Aftercare only | $275.42 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $208.93 Typical High $257.04 | Professional | 56 · Pre-op care only | $181.97 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,445.44 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,445.44 | $1,778.28 |
Where Kentucky sits
The same service costs 6.5 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· 44th of 51
$2,239
AK $8,710TX $1,349
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.