How much rates vary
Facilitymedian $2,754 · 10th to 90th $977 to $11,220Professionalmedian $2,512 · 10th to 90th $1,995 to $3,890
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 $2,630.27 Typical High $7,943.28 | Facility | None | $1,000.00 | $2,630.27 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,398.83 Typical High $2,754.23 | Professional | None | $2,089.30 | $2,398.83 | $2,754.23 |
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 $1,995.26 Median $2,454.71 Typical High $3,467.37 | Professional | None | $1,995.26 | $2,454.71 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,513.56 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,258.93 | $1,513.56 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $389.05 Typical High $549.54 | Professional | 80 · Assistant surgeon | $323.59 | $389.05 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $338.84 Typical High $478.63 | Professional | AS · PA/NP assist | $281.84 | $338.84 | $478.63 |
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 $2,089.30 Median $3,019.95 Typical High $3,630.78 | Professional | None | $2,089.30 | $3,019.95 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $3,890.45 Typical High $10,964.78 | Facility | None | $34.67 | $3,890.45 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $21,877.62 | Professional | None | $2,344.23 | $3,162.28 | $21,877.62 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,905.46 | Professional | None | $33.11 | $33.11 | $1,905.46 |
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 $2,454.71 Median $2,951.21 Typical High $4,365.16 | Professional | None | $2,454.71 | $2,951.21 | $4,365.16 |
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 $1,380.38 | Professional | 52 · Reduced service | $1,047.13 | $1,202.26 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $478.63 Typical High $562.34 | Professional | 53 · Discontinued | $416.87 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,778.28 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,584.89 | $1,778.28 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $363.08 Typical High $416.87 | Professional | 55 · Aftercare only | $316.23 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $239.88 Typical High $275.42 | Professional | 56 · Pre-op care only | $208.93 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,659.59 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,659.59 | $1,949.84 |
Where Kentucky sits
The same service costs 25.7 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· 43rd of 51
$2,512
AK $10,000TX $389
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.