How much rates vary
Facilitymedian $2,455 · 10th to 90th $832 to $8,511Professionalmedian $977 · 10th to 90th $776 to $1,585
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 $776.25 Median $977.24 Typical High $2,630.27 | Facility | None | $776.25 | $977.24 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,288.25 | Professional | None | $776.25 | $891.25 | $1,288.25 |
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 $741.31 Median $954.99 Typical High $1,548.82 | Professional | None | $741.31 | $954.99 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,445.44 Typical High $2,290.87 | Professional | 50 · Both sides | $1,122.02 | $1,445.44 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $154.88 Typical High $245.47 | Professional | 80 · Assistant surgeon | $120.23 | $154.88 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $134.90 Typical High $213.80 | Professional | AS · PA/NP assist | $104.71 | $134.90 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $1,348.96 Typical High $11,220.18 | Facility | None | $831.76 | $1,348.96 | $11,220.18 |
CareSource Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,412.54 | Professional | None | $776.25 | $1,148.15 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $8,128.31 | Facility | None | $1,479.11 | $1,862.09 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $7,413.10 | Professional | None | $870.96 | $1,202.26 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $512.86 | Professional | None | $33.11 | $33.11 | $512.86 |
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 $912.01 Median $1,096.48 Typical High $1,621.81 | Professional | None | $912.01 | $1,096.48 | $1,621.81 |
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 $389.05 Median $446.68 Typical High $575.44 | Professional | 52 · Reduced service | $389.05 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $177.83 Typical High $229.09 | Professional | 53 · Discontinued | $154.88 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $676.08 Typical High $870.96 | Professional | 54 · Surgery only | $588.84 | $676.08 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $134.90 Typical High $173.78 | Professional | 55 · Aftercare only | $117.49 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $89.13 Typical High $114.82 | Professional | 56 · Pre-op care only | $77.62 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $630.96 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $549.54 | $630.96 | $812.83 |
Where Kentucky sits
The same service costs 7.9 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
$1,000
AK $3,715TX $468
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.