How much rates vary
Facilitymedian $2,455 · 10th to 90th $832 to $9,333Professionalmedian $891 · 10th to 90th $708 to $1,380
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 $741.31 Median $912.01 Typical High $1,445.44 | Facility | None | $741.31 | $912.01 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,122.02 | Professional | None | $741.31 | $851.14 | $1,122.02 |
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 $707.95 Median $870.96 Typical High $1,318.26 | Professional | None | $707.95 | $870.96 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,318.26 Typical High $1,995.26 | Professional | 50 · Both sides | $1,047.13 | $1,318.26 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $549.54 Typical High $831.76 | Professional | 62 · Two surgeons | $446.68 | $549.54 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $141.25 Typical High $213.80 | Professional | 80 · Assistant surgeon | $112.20 | $141.25 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $123.03 Typical High $186.21 | Professional | AS · PA/NP assist | $97.72 | $123.03 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $1,288.25 Typical High $15,488.17 | Facility | None | $776.25 | $1,288.25 | $15,488.17 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,318.26 | Professional | None | $724.44 | $1,071.52 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,862.09 Typical High $10,715.19 | Facility | None | $954.99 | $1,862.09 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $5,888.44 | Professional | None | $812.83 | $1,071.52 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $501.19 | Professional | None | $33.11 | $33.11 | $501.19 |
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 $812.83 Median $1,000.00 Typical High $1,513.56 | Professional | None | $812.83 | $1,000.00 | $1,513.56 |
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 $371.54 Median $426.58 Typical High $549.54 | Professional | 52 · Reduced service | $371.54 | $426.58 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $169.82 Typical High $218.78 | Professional | 53 · Discontinued | $147.91 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $630.96 Typical High $812.83 | Professional | 54 · Surgery only | $549.54 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $125.89 Typical High $162.18 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $85.11 Typical High $109.65 | Professional | 56 · Pre-op care only | $74.13 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $588.84 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $512.86 | $588.84 | $758.58 |
Where Kentucky sits
The same service costs 7.5 times more in Alaska than in Hawaii. 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 $19,036HI $2,542
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.