How much rates vary
Facilitymedian $2,344 · 10th to 90th $692 to $8,511Professionalmedian $617 · 10th to 90th $501 to $977
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 $537.03 Median $660.69 Typical High $8,511.38 | Facility | None | $537.03 | $660.69 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $758.58 | Professional | None | $537.03 | $616.60 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $9,332.54 | Facility | None | $1,071.52 | $3,311.31 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $912.01 | Professional | None | $501.19 | $616.60 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $933.25 Typical High $1,348.96 | Professional | 50 · Both sides | $758.58 | $933.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $97.72 Typical High $144.54 | Professional | 80 · Assistant surgeon | $81.28 | $97.72 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $87.10 Typical High $125.89 | Professional | AS · PA/NP assist | $70.79 | $87.10 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $933.25 Typical High $5,888.44 | Facility | None | $562.34 | $933.25 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $954.99 | Professional | None | $588.84 | $794.33 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $4,466.84 | Facility | None | $741.31 | $2,290.87 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $4,073.80 | Professional | None | $588.84 | $741.31 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $346.74 | Professional | None | $33.11 | $33.11 | $346.74 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,096.48 | Professional | None | $575.44 | $724.44 | $1,096.48 |
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 $269.15 Median $309.03 Typical High $380.19 | Professional | 52 · Reduced service | $269.15 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $123.03 Typical High $154.88 | Professional | 53 · Discontinued | $107.15 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $457.09 Typical High $575.44 | Professional | 54 · Surgery only | $398.11 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $91.20 Typical High $114.82 | Professional | 55 · Aftercare only | $81.28 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $61.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $53.70 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $426.58 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $371.54 | $426.58 | $537.03 |
Where Kentucky sits
The same service costs 8.3 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
$646
AK $2,570TX $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.