How much rates vary
Facilitymedian $2,188 · 10th to 90th $776 to $8,128Professionalmedian $851 · 10th to 90th $692 to $1,288
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 $724.44 Median $891.25 Typical High $2,630.27 | Facility | None | $724.44 | $891.25 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $977.24 | Professional | None | $724.44 | $831.76 | $977.24 |
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 $691.83 Median $851.14 Typical High $1,202.26 | Professional | None | $691.83 | $851.14 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,258.93 Typical High $1,778.28 | Professional | 50 · Both sides | $1,047.13 | $1,258.93 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $537.03 Typical High $758.58 | Professional | 62 · Two surgeons | $436.52 | $537.03 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $190.55 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $165.96 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $1,258.93 Typical High $2,691.53 | Facility | None | $676.08 | $1,258.93 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,288.25 | Professional | None | $776.25 | $1,071.52 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,862.09 Typical High $2,511.89 | Facility | None | $954.99 | $1,862.09 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $5,128.61 | Professional | None | $812.83 | $1,000.00 | $5,128.61 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $512.86 | Professional | None | $33.11 | $33.11 | $512.86 |
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 $794.33 Median $977.24 Typical High $1,479.11 | Professional | None | $794.33 | $977.24 | $1,479.11 |
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 $363.08 Median $416.87 Typical High $489.78 | Professional | 52 · Reduced service | $363.08 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $165.96 Typical High $199.53 | Professional | 53 · Discontinued | $144.54 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $741.31 | Professional | 54 · Surgery only | $549.54 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $147.91 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $72.44 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $691.83 |
Where Kentucky sits
The same service costs 7.9 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· 43rd of 51
$891
AK $3,467TX $437
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.