How much rates vary
Facilitymedian $2,630 · 10th to 90th $871 to $9,772Professionalmedian $1,023 · 10th to 90th $832 to $1,622
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 $794.33 Median $1,071.52 Typical High $2,630.27 | Facility | None | $794.33 | $1,071.52 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,288.25 | Professional | None | $870.96 | $977.24 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,548.82 | Professional | None | $831.76 | $1,023.29 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,548.82 Typical High $2,290.87 | Professional | 50 · Both sides | $1,230.27 | $1,548.82 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $645.65 Typical High $977.24 | Professional | 62 · Two surgeons | $524.81 | $645.65 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $165.96 Typical High $245.47 | Professional | 80 · Assistant surgeon | $131.83 | $165.96 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $144.54 Typical High $213.80 | Professional | AS · PA/NP assist | $114.82 | $144.54 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,513.56 Typical High $14,125.38 | Facility | None | $912.01 | $1,513.56 | $14,125.38 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,548.82 | Professional | None | $912.01 | $1,258.93 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $10,964.78 | Facility | None | $1,621.81 | $1,862.09 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $6,760.83 | Professional | None | $954.99 | $1,258.93 | $6,760.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $616.60 | Professional | None | $33.11 | $33.11 | $616.60 |
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 $954.99 Median $1,174.90 Typical High $1,778.28 | Professional | None | $954.99 | $1,174.90 | $1,778.28 |
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 $436.52 Median $489.78 Typical High $630.96 | Professional | 52 · Reduced service | $436.52 | $489.78 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $199.53 Typical High $257.04 | Professional | 53 · Discontinued | $173.78 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $741.31 Typical High $954.99 | Professional | 54 · Surgery only | $645.65 | $741.31 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $147.91 Typical High $190.55 | Professional | 55 · Aftercare only | $128.82 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $125.89 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $691.83 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $602.56 | $691.83 | $891.25 |
Where Kentucky sits
The same service costs 7.2 times more in Alaska than in Hawaii. 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 $19,657HI $2,734
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.