How much rates vary
Facilitymedian $1,995 · 10th to 90th $661 to $8,128Professionalmedian $603 · 10th to 90th $490 to $912
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 $2,630.27 | Facility | None | $537.03 | $660.69 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $660.69 | Professional | None | $537.03 | $602.56 | $660.69 |
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 $489.78 Median $588.84 Typical High $812.83 | Professional | None | $489.78 | $588.84 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $891.25 Typical High $1,202.26 | Professional | 50 · Both sides | $724.44 | $891.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $371.54 Typical High $512.86 | Professional | 62 · Two surgeons | $309.03 | $371.54 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $93.33 Typical High $128.82 | Professional | 80 · Assistant surgeon | $77.62 | $93.33 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $83.18 Typical High $112.20 | Professional | AS · PA/NP assist | $67.61 | $83.18 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $933.25 Typical High $2,691.53 | Facility | None | $562.34 | $933.25 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $954.99 | Professional | None | $524.81 | $776.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,819.70 Typical High $1,995.26 | Facility | None | $691.83 | $1,819.70 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $3,548.13 | Professional | None | $588.84 | $741.31 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $302.00 | Professional | None | $33.11 | $33.11 | $302.00 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $1,071.52 | Professional | None | $549.54 | $707.95 | $1,071.52 |
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 $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $269.15 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $457.09 Typical High $501.19 | Professional | 54 · Surgery only | $398.11 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $91.20 Typical High $100.00 | Professional | 55 · Aftercare only | $79.43 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $53.70 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $426.58 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $371.54 | $426.58 | $467.74 |
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· 45th of 51
$631
AK $2,570TX $331
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.