How much rates vary
Facilitymedian $2,089 · 10th to 90th $794 to $8,318Professionalmedian $813 · 10th to 90th $646 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 $660.69 Median $812.83 Typical High $2,630.27 | Facility | None | $660.69 | $812.83 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,071.52 | Professional | None | $660.69 | $741.31 | $1,071.52 |
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 $616.60 Median $812.83 Typical High $1,380.38 | Professional | None | $616.60 | $812.83 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,230.27 Typical High $2,041.74 | Professional | 50 · Both sides | $933.25 | $1,230.27 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $128.82 Typical High $218.78 | Professional | 80 · Assistant surgeon | $100.00 | $128.82 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $114.82 Typical High $190.55 | Professional | AS · PA/NP assist | $87.10 | $114.82 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $1,148.15 Typical High $2,691.53 | Facility | None | $691.83 | $1,148.15 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,174.90 | Professional | None | $776.25 | $954.99 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,819.70 Typical High $1,995.26 | Facility | None | $851.14 | $1,819.70 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $6,456.54 | Professional | None | $724.44 | $1,023.29 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $436.52 | Professional | None | $33.11 | $33.11 | $436.52 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,348.96 | Professional | None | $776.25 | $933.25 | $1,348.96 |
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 $323.59 Median $371.54 Typical High $478.63 | Professional | 52 · Reduced service | $323.59 | $371.54 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $147.91 Typical High $190.55 | Professional | 53 · Discontinued | $131.83 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $724.44 | Professional | 54 · Surgery only | $489.78 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $112.20 Typical High $144.54 | Professional | 55 · Aftercare only | $97.72 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $74.13 Typical High $95.50 | Professional | 56 · Pre-op care only | $66.07 | $74.13 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $524.81 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $457.09 | $524.81 | $676.08 |
Where Kentucky sits
The same service costs 8.3 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· 39th of 51
$851
AK $3,162TX $380
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.