How much rates vary
Facilitymedian $2,884 · 10th to 90th $912 to $10,233Professionalmedian $1,072 · 10th to 90th $813 to $1,820
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 $1,148.15 Typical High $2,630.27 | Facility | None | $794.33 | $1,148.15 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,258.93 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,230.27 | Professional | None | $851.14 | $1,047.13 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,584.89 Typical High $1,862.09 | Professional | 50 · Both sides | $1,288.25 | $1,584.89 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $660.69 Typical High $776.25 | Professional | 62 · Two surgeons | $537.03 | $660.69 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $165.96 Typical High $194.98 | Professional | 80 · Assistant surgeon | $138.04 | $165.96 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $147.91 Typical High $173.78 | Professional | AS · PA/NP assist | $120.23 | $147.91 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $7,943.28 | Facility | None | $1,202.26 | $1,995.26 | $7,943.28 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,621.81 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,137.96 Typical High $5,888.44 | Facility | None | $34.67 | $2,137.96 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,513.56 Typical High $5,888.44 | Professional | None | $954.99 | $1,513.56 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $380.19 | Professional | None | $33.11 | $33.11 | $380.19 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,348.96 Typical High $2,344.23 | Professional | None | $707.95 | $1,348.96 | $2,344.23 |
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 $562.34 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $562.34 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $223.87 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $831.76 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $112.20 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $1,000.00 |
Where Kentucky sits
The same service costs 8.9 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· 46th of 51
$1,072
AK $5,495TX $617
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.