How much rates vary
Facilitymedian $2,291 · 10th to 90th $977 to $14,791Professionalmedian $1,698 · 10th to 90th $1,413 to $3,090
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 $1,202.26 Median $1,862.09 Typical High $8,511.38 | Facility | None | $1,202.26 | $1,862.09 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,698.24 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,659.59 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,511.89 Typical High $3,548.13 | Professional | 50 · Both sides | $2,089.30 | $2,511.89 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $263.03 Typical High $371.54 | Professional | 80 · Assistant surgeon | $223.87 | $263.03 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $331.13 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $2,630.27 Typical High $22,908.68 | Facility | None | $1,584.89 | $2,630.27 | $22,908.68 |
CareSource Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,621.81 | $2,187.76 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,754.23 Typical High $14,454.40 | Facility | None | $34.67 | $2,754.23 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $7,762.47 | Professional | None | $1,659.59 | $2,187.76 | $7,762.47 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,096.48 | Professional | None | $33.11 | $33.11 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,162.28 Typical High $14,791.08 | Facility | None | $1,148.15 | $3,162.28 | $14,791.08 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,905.46 | $2,089.30 | $3,311.31 |
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 $758.58 Median $851.14 Typical High $933.25 | Professional | 52 · Reduced service | $758.58 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $338.84 Typical High $371.54 | Professional | 53 · Discontinued | $302.00 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,288.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,122.02 | $1,288.25 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $257.04 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $169.82 Typical High $186.21 | Professional | 56 · Pre-op care only | $151.36 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,202.26 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,202.26 | $1,288.25 |
Where Kentucky sits
The same service costs 7.8 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $31,233KY $3,989
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.