How much rates vary
Facilitymedian $2,692 · 10th to 90th $741 to $10,000Professionalmedian $676 · 10th to 90th $550 to $1,047
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 $575.44 Median $724.44 Typical High $8,511.38 | Facility | None | $575.44 | $724.44 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $870.96 | Professional | None | $575.44 | $660.69 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,023.29 | Professional | None | $549.54 | $676.08 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,000.00 Typical High $1,513.56 | Professional | 50 · Both sides | $812.83 | $1,000.00 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $107.15 Typical High $162.18 | Professional | 80 · Assistant surgeon | $87.10 | $107.15 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $93.33 Typical High $141.25 | Professional | AS · PA/NP assist | $75.86 | $93.33 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $5,888.44 | Facility | None | $537.03 | $1,000.00 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,000.00 | Professional | None | $616.60 | $831.76 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $4,466.84 | Facility | None | $851.14 | $2,511.89 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $4,570.88 | Professional | None | $645.65 | $851.14 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $363.08 | Professional | None | $33.11 | $33.11 | $363.08 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,174.90 | Professional | None | $630.96 | $776.25 | $1,174.90 |
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 $288.40 Median $331.13 Typical High $426.58 | Professional | 52 · Reduced service | $288.40 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $131.83 Typical High $169.82 | Professional | 53 · Discontinued | $117.49 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $501.19 Typical High $645.65 | Professional | 54 · Surgery only | $436.52 | $501.19 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $100.00 Typical High $128.82 | Professional | 55 · Aftercare only | $87.10 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $66.07 Typical High $85.11 | Professional | 56 · Pre-op care only | $57.54 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $467.74 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $407.38 | $467.74 | $602.56 |
Where Kentucky sits
The same service costs 7.8 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· 42nd of 51
$724
AK $2,818TX $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.