How much rates vary
Facilitymedian $2,570 · 10th to 90th $759 to $8,318Professionalmedian $724 · 10th to 90th $589 to $1,122
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 $616.60 Median $758.58 Typical High $2,630.27 | Facility | None | $616.60 | $758.58 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $851.14 | Professional | None | $616.60 | $707.95 | $851.14 |
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 $588.84 Median $724.44 Typical High $1,023.29 | Professional | None | $588.84 | $724.44 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | 50 · Both sides | $870.96 | $1,071.52 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $114.82 Typical High $165.96 | Professional | 80 · Assistant surgeon | $93.33 | $114.82 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $100.00 Typical High $144.54 | Professional | AS · PA/NP assist | $81.28 | $100.00 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $5,888.44 | Facility | None | $645.65 | $1,071.52 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,096.48 | Professional | None | $602.56 | $891.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,862.09 Typical High $4,466.84 | Facility | None | $794.33 | $1,862.09 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $4,466.84 | Professional | None | $676.08 | $851.14 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $416.87 | Professional | None | $33.11 | $33.11 | $416.87 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,258.93 | Professional | None | $660.69 | $831.76 | $1,258.93 |
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 $309.03 Median $346.74 Typical High $426.58 | Professional | 52 · Reduced service | $309.03 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $141.25 Typical High $169.82 | Professional | 53 · Discontinued | $123.03 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $630.96 | Professional | 54 · Surgery only | $457.09 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $125.89 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $70.79 Typical High $85.11 | Professional | 56 · Pre-op care only | $61.66 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $489.78 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $426.58 | $489.78 | $588.84 |
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· 41st of 51
$759
AK $2,951TX $380
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.