How much rates vary
Facilitymedian $2,884 · 10th to 90th $933 to $11,482Professionalmedian $1,047 · 10th to 90th $832 to $1,622
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 $891.25 Median $1,122.02 Typical High $8,511.38 | Facility | None | $891.25 | $1,122.02 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,230.27 | Professional | None | $912.01 | $1,023.29 | $1,230.27 |
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 $831.76 Median $1,000.00 Typical High $1,412.54 | Professional | None | $831.76 | $1,000.00 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,479.11 Typical High $2,137.96 | Professional | 50 · Both sides | $1,230.27 | $1,479.11 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $158.49 Typical High $229.09 | Professional | 80 · Assistant surgeon | $131.83 | $158.49 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $138.04 Typical High $199.53 | Professional | AS · PA/NP assist | $114.82 | $138.04 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $16,595.87 | Facility | None | $954.99 | $1,584.89 | $16,595.87 |
CareSource Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,621.81 | Professional | None | $977.24 | $1,318.26 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $11,481.54 | Facility | None | $1,698.24 | $2,511.89 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $6,456.54 | Professional | None | $1,000.00 | $1,258.93 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $616.60 | Professional | None | $33.11 | $33.11 | $616.60 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $9,772.37 | Facility | None | $831.76 | $2,290.87 | $9,772.37 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,862.09 | Professional | None | $977.24 | $1,230.27 | $1,862.09 |
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 $446.68 Median $512.86 Typical High $616.60 | Professional | 52 · Reduced service | $446.68 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $204.17 Typical High $245.47 | Professional | 53 · Discontinued | $181.97 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $776.25 Typical High $912.01 | Professional | 54 · Surgery only | $676.08 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $154.88 Typical High $181.97 | Professional | 55 · Aftercare only | $134.90 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $102.33 Typical High $123.03 | Professional | 56 · Pre-op care only | $91.20 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $724.44 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $630.96 | $724.44 | $851.14 |
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· 45th of 51
$1,072
AK $4,365TX $550
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.