How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,000 to $9,333Professionalmedian $1,230 · 10th to 90th $977 to $1,995
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 $851.14 Median $1,230.27 Typical High $8,511.38 | Facility | None | $851.14 | $1,230.27 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,122.02 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $9,549.93 | Facility | None | $1,071.52 | $3,311.31 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,949.84 | Professional | None | $954.99 | $1,230.27 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,862.09 Typical High $2,951.21 | Professional | 50 · Both sides | $1,412.54 | $1,862.09 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $776.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $602.56 | $776.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $194.98 Typical High $316.23 | Professional | 80 · Assistant surgeon | $151.36 | $194.98 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $173.78 Typical High $275.42 | Professional | AS · PA/NP assist | $131.83 | $173.78 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $7,585.78 | Facility | None | $1,047.13 | $1,737.80 | $7,585.78 |
CareSource Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,445.44 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $6,165.95 | Facility | None | $1,288.25 | $2,290.87 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $9,120.11 | Professional | None | $1,096.48 | $1,513.56 | $9,120.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $707.95 | Professional | None | $33.11 | $33.11 | $707.95 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,412.54 | $2,041.74 |
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 $501.19 Median $562.34 Typical High $724.44 | Professional | 52 · Reduced service | $501.19 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $229.09 Typical High $288.40 | Professional | 53 · Discontinued | $199.53 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $851.14 Typical High $1,096.48 | Professional | 54 · Surgery only | $741.31 | $851.14 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $169.82 Typical High $218.78 | Professional | 55 · Aftercare only | $147.91 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $112.20 Typical High $144.54 | Professional | 56 · Pre-op care only | $100.00 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $794.33 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $691.83 | $794.33 | $1,023.29 |
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· 38th of 51
$1,288
AK $4,786TX $575
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.