How much rates vary
Facilitymedian $1,349 · 10th to 90th $447 to $3,020Professionalmedian $407 · 10th to 90th $324 to $617
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 $363.08 Median $446.68 Typical High $3,801.89 | Facility | None | $363.08 | $446.68 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $489.78 | Professional | None | $363.08 | $407.38 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $575.44 | Professional | None | $323.59 | $398.11 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $588.84 Typical High $851.14 | Professional | 50 · Both sides | $489.78 | $588.84 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $204.17 Median $245.47 Typical High $363.08 | Professional | 62 · Two surgeons | $204.17 | $245.47 | $363.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $63.10 Typical High $91.20 | Professional | 80 · Assistant surgeon | $52.48 | $63.10 | $91.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $54.95 Typical High $79.43 | Professional | AS · PA/NP assist | $45.71 | $54.95 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $630.96 Typical High $2,691.53 | Facility | None | $380.19 | $630.96 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $645.65 | Professional | None | $389.05 | $524.81 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,318.26 Typical High $1,995.26 | Facility | None | $478.63 | $1,318.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $2,570.40 | Professional | None | $398.11 | $489.78 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $208.93 | Professional | None | $33.11 | $33.11 | $208.93 |
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 $371.54 Median $467.74 Typical High $724.44 | Professional | None | $371.54 | $467.74 | $724.44 |
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 $181.97 Median $204.17 Typical High $245.47 | Professional | 52 · Reduced service | $181.97 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $83.18 Typical High $97.72 | Professional | 53 · Discontinued | $72.44 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $269.15 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $53.70 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $288.40 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $251.19 | $288.40 | $338.84 |
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
$427
AK $1,738TX $209
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.