How much rates vary
Facilitymedian $1,862 · 10th to 90th $631 to $7,586Professionalmedian $631 · 10th to 90th $501 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 $512.86 Median $630.96 Typical High $2,630.27 | Facility | None | $512.86 | $630.96 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $851.14 | Professional | None | $512.86 | $575.44 | $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 $478.63 Median $630.96 Typical High $1,122.02 | Professional | None | $478.63 | $630.96 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $954.99 Typical High $1,698.24 | Professional | 50 · Both sides | $724.44 | $954.99 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $100.00 Typical High $177.83 | Professional | 80 · Assistant surgeon | $75.86 | $100.00 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $89.13 Typical High $158.49 | Professional | AS · PA/NP assist | $67.61 | $89.13 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $1,412.54 | Facility | None | $537.03 | $891.25 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $891.25 | Professional | None | $501.19 | $724.44 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,862.09 | Facility | None | $912.01 | $1,000.00 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $5,495.41 | Professional | None | $562.34 | $794.33 | $5,495.41 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $323.59 | Professional | None | $33.11 | $33.11 | $323.59 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,047.13 | Professional | None | $588.84 | $724.44 | $1,047.13 |
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 $257.04 Median $288.40 Typical High $380.19 | Professional | 52 · Reduced service | $257.04 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $117.49 Typical High $151.36 | Professional | 53 · Discontinued | $102.33 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $436.52 Typical High $562.34 | Professional | 54 · Surgery only | $380.19 | $436.52 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $87.10 Typical High $112.20 | Professional | 55 · Aftercare only | $75.86 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $75.86 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $407.38 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $354.81 | $407.38 | $524.81 |
Where Kentucky sits
The same service costs 7.4 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· 40th of 51
$661
AK $2,455TX $331
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.