How much rates vary
Facilitymedian $3,090 · 10th to 90th $977 to $10,471Professionalmedian $955 · 10th to 90th $776 to $1,514
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 $812.83 Median $1,000.00 Typical High $8,511.38 | Facility | None | $812.83 | $1,000.00 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,230.27 | Professional | None | $812.83 | $912.01 | $1,230.27 |
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 $776.25 Median $954.99 Typical High $1,479.11 | Professional | None | $776.25 | $954.99 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,445.44 Typical High $2,238.72 | Professional | 50 · Both sides | $1,174.90 | $1,445.44 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $602.56 Typical High $933.25 | Professional | 62 · Two surgeons | $489.78 | $602.56 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $154.88 Typical High $239.88 | Professional | 80 · Assistant surgeon | $123.03 | $154.88 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $134.90 Typical High $208.93 | Professional | AS · PA/NP assist | $109.65 | $134.90 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $1,412.54 Typical High $5,888.44 | Facility | None | $851.14 | $1,412.54 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,445.44 | Professional | None | $870.96 | $1,174.90 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $5,623.41 | Facility | None | $1,513.56 | $2,511.89 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $6,456.54 | Professional | None | $891.25 | $1,202.26 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $602.56 | Professional | None | $33.11 | $33.11 | $602.56 |
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 $891.25 Median $1,096.48 Typical High $1,659.59 | Professional | None | $891.25 | $1,096.48 | $1,659.59 |
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 $407.38 Median $457.09 Typical High $588.84 | Professional | 52 · Reduced service | $407.38 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $181.97 Typical High $234.42 | Professional | 53 · Discontinued | $162.18 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $691.83 Typical High $891.25 | Professional | 54 · Surgery only | $602.56 | $691.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $138.04 Typical High $177.83 | Professional | 55 · Aftercare only | $120.23 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $91.20 Typical High $117.49 | Professional | 56 · Pre-op care only | $81.28 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $645.65 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $562.34 | $645.65 | $831.76 |
Where Kentucky sits
The same service costs 7.9 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· 40th of 51
$1,000
AK $3,890TX $490
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.