How much rates vary
Facilitymedian $3,090 · 10th to 90th $977 to $10,715Professionalmedian $1,000 · 10th to 90th $813 to $1,549
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 $851.14 Median $1,047.13 Typical High $8,511.38 | Facility | None | $851.14 | $1,047.13 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,174.90 | Professional | None | $851.14 | $977.24 | $1,174.90 |
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 $812.83 Median $1,000.00 Typical High $1,445.44 | Professional | None | $812.83 | $1,000.00 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,513.56 Typical High $2,137.96 | Professional | 50 · Both sides | $1,202.26 | $1,513.56 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $158.49 Typical High $229.09 | Professional | 80 · Assistant surgeon | $128.82 | $158.49 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $138.04 Typical High $199.53 | Professional | AS · PA/NP assist | $112.20 | $138.04 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $11,220.18 | Facility | None | $912.01 | $1,479.11 | $11,220.18 |
CareSource Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,548.82 | Professional | None | $851.14 | $1,258.93 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $8,128.31 | Facility | None | $1,621.81 | $2,511.89 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $6,165.95 | Professional | None | $954.99 | $1,202.26 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $588.84 | Professional | None | $33.11 | $33.11 | $588.84 |
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 $933.25 Median $1,148.15 Typical High $1,737.80 | Professional | None | $933.25 | $1,148.15 | $1,737.80 |
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 $426.58 Median $489.78 Typical High $588.84 | Professional | 52 · Reduced service | $426.58 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $194.98 Typical High $234.42 | Professional | 53 · Discontinued | $169.82 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $870.96 | Professional | 54 · Surgery only | $645.65 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $173.78 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $97.72 Typical High $117.49 | Professional | 56 · Pre-op care only | $85.11 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $812.83 |
Where Kentucky sits
The same service costs 8.5 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· 44th of 51
$1,047
AK $4,074TX $479
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.