How much rates vary
Facilitymedian $2,138 · 10th to 90th $871 to $8,318Professionalmedian $1,072 · 10th to 90th $851 to $1,698
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 $794.33 Median $1,071.52 Typical High $2,630.27 | Facility | None | $794.33 | $1,071.52 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,412.54 | Professional | None | $870.96 | $977.24 | $1,412.54 |
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 $812.83 Median $1,047.13 Typical High $1,698.24 | Professional | None | $812.83 | $1,047.13 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,584.89 Typical High $2,511.89 | Professional | 50 · Both sides | $1,230.27 | $1,584.89 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $169.82 Typical High $269.15 | Professional | 80 · Assistant surgeon | $131.83 | $169.82 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $147.91 Typical High $234.42 | Professional | AS · PA/NP assist | $114.82 | $147.91 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,513.56 Typical High $2,691.53 | Facility | None | $912.01 | $1,513.56 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,548.82 | Professional | None | $933.25 | $1,258.93 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $1,995.26 | Facility | None | $1,621.81 | $1,862.09 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $7,413.10 | Professional | None | $954.99 | $1,258.93 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $562.34 | Professional | None | $33.11 | $33.11 | $562.34 |
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 $977.24 Median $1,202.26 Typical High $1,778.28 | Professional | None | $977.24 | $1,202.26 | $1,778.28 |
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 $426.58 Median $489.78 Typical High $630.96 | Professional | 52 · Reduced service | $426.58 | $489.78 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $194.98 Typical High $251.19 | Professional | 53 · Discontinued | $173.78 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $741.31 Typical High $954.99 | Professional | 54 · Surgery only | $645.65 | $741.31 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $147.91 Typical High $190.55 | Professional | 55 · Aftercare only | $128.82 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $125.89 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $691.83 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $602.56 | $691.83 | $891.25 |
Where Kentucky sits
The same service costs 8.9 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· 41st of 51
$1,096
AK $4,169TX $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.