How much rates vary
Facilitymedian $2,344 · 10th to 90th $617 to $8,318Professionalmedian $562 · 10th to 90th $447 to $891
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 $478.63 Median $602.56 Typical High $2,630.27 | Facility | None | $478.63 | $602.56 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $724.44 | Professional | None | $478.63 | $549.54 | $724.44 |
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 $446.68 Median $562.34 Typical High $812.83 | Professional | None | $446.68 | $562.34 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $831.76 Typical High $1,230.27 | Professional | 50 · Both sides | $676.08 | $831.76 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $354.81 Typical High $512.86 | Professional | 62 · Two surgeons | $281.84 | $354.81 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $89.13 Typical High $131.83 | Professional | 80 · Assistant surgeon | $72.44 | $89.13 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $77.62 Typical High $114.82 | Professional | AS · PA/NP assist | $63.10 | $77.62 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $5,888.44 | Facility | None | $512.86 | $831.76 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $870.96 | Professional | None | $478.63 | $707.95 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,862.09 Typical High $4,466.84 | Facility | None | $933.25 | $1,862.09 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $3,801.89 | Professional | None | $537.03 | $691.83 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $281.84 | Professional | None | $33.11 | $33.11 | $281.84 |
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 $512.86 Median $645.65 Typical High $977.24 | Professional | None | $512.86 | $645.65 | $977.24 |
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 $239.88 Median $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $239.88 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $95.50 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $537.03 | Professional | 54 · Surgery only | $363.08 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $83.18 Typical High $107.15 | Professional | 55 · Aftercare only | $72.44 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $501.19 |
Where Kentucky sits
The same service costs 7.6 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· 42nd of 51
$589
AK $2,344TX $309
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.