How much rates vary
Facilitymedian $1,995 · 10th to 90th $631 to $8,128Professionalmedian $631 · 10th to 90th $513 to $1,096
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 $588.84 Typical High $933.25 | Professional | None | $512.86 | $588.84 | $933.25 |
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 $1,096.48 | Professional | None | $478.63 | $630.96 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $954.99 Typical High $1,659.59 | Professional | 50 · Both sides | $707.95 | $954.99 | $1,659.59 |
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 $66.07 Median $89.13 Typical High $154.88 | Professional | AS · PA/NP assist | $66.07 | $89.13 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $2,691.53 | Facility | None | $549.54 | $891.25 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $912.01 | Professional | None | $562.34 | $758.58 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $1,995.26 | Facility | None | $1,000.00 | $1,862.09 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $5,495.41 | Professional | None | $575.44 | $812.83 | $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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,071.52 | Professional | None | $602.56 | $724.44 | $1,071.52 |
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 $295.12 Typical High $380.19 | Professional | 52 · Reduced service | $257.04 | $295.12 | $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 $389.05 Median $436.52 Typical High $562.34 | Professional | 54 · Surgery only | $389.05 | $436.52 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $114.82 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $58.88 Typical High $75.86 | Professional | 56 · Pre-op care only | $51.29 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $363.08 | $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· 43rd 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.