How much rates vary
Facilitymedian $2,570 · 10th to 90th $832 to $8,511Professionalmedian $832 · 10th to 90th $676 to $1,349
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 $741.31 Median $912.01 Typical High $2,630.27 | Facility | None | $741.31 | $912.01 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,148.15 | Professional | None | $741.31 | $831.76 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,709.64 | Facility | None | $954.99 | $2,884.03 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,258.93 | Professional | None | $676.08 | $794.33 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $1,862.09 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $128.82 Typical High $199.53 | Professional | 80 · Assistant surgeon | $109.65 | $128.82 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $173.78 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $1,288.25 Typical High $5,888.44 | Facility | None | $776.25 | $1,288.25 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,318.26 | Professional | None | $794.33 | $1,047.13 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,862.09 Typical High $4,466.84 | Facility | None | $954.99 | $1,862.09 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $6,025.60 | Professional | None | $812.83 | $1,023.29 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $478.63 | Professional | None | $33.11 | $33.11 | $478.63 |
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 $794.33 Median $1,000.00 Typical High $1,513.56 | Professional | None | $794.33 | $1,000.00 | $1,513.56 |
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 $363.08 Median $416.87 Typical High $537.03 | Professional | 52 · Reduced service | $363.08 | $416.87 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $213.80 | Professional | 53 · Discontinued | $147.91 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $630.96 Typical High $812.83 | Professional | 54 · Surgery only | $549.54 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $125.89 Typical High $162.18 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $107.15 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $588.84 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $512.86 | $588.84 | $758.58 |
Where Kentucky sits
The same service costs 8.1 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
$871
AK $3,548TX $437
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.