How much rates vary
Facilitymedian $1,660 · 10th to 90th $832 to $8,511Professionalmedian $1,230 · 10th to 90th $977 to $2,042
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 $1,288.25 Typical High $8,511.38 | Facility | None | $891.25 | $1,288.25 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,412.54 | $1,584.89 |
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 $977.24 Median $1,202.26 Typical High $1,479.11 | Professional | None | $977.24 | $1,202.26 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,778.28 Typical High $2,187.76 | Professional | 50 · Both sides | $1,479.11 | $1,778.28 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $758.58 Typical High $912.01 | Professional | 62 · Two surgeons | $616.60 | $758.58 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $190.55 Typical High $239.88 | Professional | 80 · Assistant surgeon | $154.88 | $190.55 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $204.17 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,238.72 | Facility | None | $1,174.90 | $1,412.54 | $2,238.72 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,862.09 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,398.83 Typical High $4,466.84 | Facility | None | $34.67 | $2,398.83 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $6,606.93 | Professional | None | $1,096.48 | $1,737.80 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $467.74 | Professional | None | $33.11 | $33.11 | $467.74 |
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 $851.14 Median $1,513.56 Typical High $2,630.27 | Professional | None | $851.14 | $1,513.56 | $2,630.27 |
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 $630.96 Median $691.83 Typical High $794.33 | Professional | 52 · Reduced service | $630.96 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $251.19 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $239.88 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $158.49 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $1,122.02 |
Where Kentucky sits
The same service costs 5.5 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 $15,938KY $2,890
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.