How much rates vary
Facilitymedian $2,630 · 10th to 90th $692 to $8,511Professionalmedian $562 · 10th to 90th $447 to $891
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 $489.78 Median $616.60 Typical High $2,630.27 | Facility | None | $489.78 | $616.60 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $724.44 | Professional | None | $489.78 | $562.34 | $724.44 |
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 $446.68 Median $549.54 Typical High $870.96 | Professional | None | $446.68 | $549.54 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $812.83 Typical High $1,318.26 | Professional | 50 · Both sides | $676.08 | $812.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $87.10 Typical High $141.25 | Professional | 80 · Assistant surgeon | $72.44 | $87.10 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $75.86 Typical High $123.03 | Professional | AS · PA/NP assist | $63.10 | $75.86 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $851.14 Typical High $5,888.44 | Facility | None | $457.09 | $851.14 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $891.25 | Professional | None | $537.03 | $724.44 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,862.09 Typical High $5,623.41 | Facility | None | $954.99 | $1,862.09 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $3,630.78 | Professional | None | $549.54 | $676.08 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $316.23 | Professional | None | $33.11 | $33.11 | $316.23 |
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 $501.19 Median $645.65 Typical High $1,000.00 | Professional | None | $501.19 | $645.65 | $1,000.00 |
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 $245.47 Median $281.84 Typical High $346.74 | Professional | 52 · Reduced service | $245.47 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $112.20 Typical High $138.04 | Professional | 53 · Discontinued | $97.72 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $524.81 | Professional | 54 · Surgery only | $371.54 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $56.23 Typical High $69.18 | Professional | 56 · Pre-op care only | $48.98 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $389.05 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $346.74 | $389.05 | $489.78 |
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· 44th of 51
$589
AK $2,399TX $309
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.