How much rates vary
Facilitymedian $2,344 · 10th to 90th $871 to $8,511Professionalmedian $1,000 · 10th to 90th $776 to $1,660
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 $812.83 Median $1,000.00 Typical High $8,511.38 | Facility | None | $812.83 | $1,000.00 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,348.96 | Professional | None | $812.83 | $933.25 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,659.59 | Professional | None | $776.25 | $954.99 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,412.54 Typical High $2,511.89 | Professional | 50 · Both sides | $1,174.90 | $1,412.54 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $602.56 Typical High $1,047.13 | Professional | 62 · Two surgeons | $489.78 | $602.56 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $151.36 Typical High $269.15 | Professional | 80 · Assistant surgeon | $125.89 | $151.36 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $131.83 Typical High $234.42 | Professional | AS · PA/NP assist | $109.65 | $131.83 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $1,412.54 Typical High $2,691.53 | Facility | None | $851.14 | $1,412.54 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,445.44 | Professional | None | $870.96 | $1,202.26 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,290.87 | Facility | None | $1,548.82 | $1,905.46 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $7,079.46 | Professional | None | $912.01 | $1,230.27 | $7,079.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $575.44 | Professional | None | $33.11 | $33.11 | $575.44 |
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 $954.99 Median $1,096.48 Typical High $1,698.24 | Professional | None | $954.99 | $1,096.48 | $1,698.24 |
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 $407.38 Median $467.74 Typical High $602.56 | Professional | 52 · Reduced service | $407.38 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $186.21 Typical High $239.88 | Professional | 53 · Discontinued | $162.18 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $691.83 Typical High $891.25 | Professional | 54 · Surgery only | $616.60 | $691.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $138.04 Typical High $177.83 | Professional | 55 · Aftercare only | $123.03 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $93.33 Typical High $120.23 | Professional | 56 · Pre-op care only | $81.28 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $645.65 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $575.44 | $645.65 | $831.76 |
Where Kentucky sits
The same service costs 16.2 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
$1,000
AK $3,890TX $240
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.