How much rates vary
Facilitymedian $2,455 · 10th to 90th $776 to $9,333Professionalmedian $794 · 10th to 90th $631 to $1,349
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 $630.96 Median $776.25 Typical High $2,630.27 | Facility | None | $630.96 | $776.25 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,148.15 | Professional | None | $630.96 | $724.44 | $1,148.15 |
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 $602.56 Median $794.33 Typical High $1,348.96 | Professional | None | $602.56 | $794.33 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,174.90 Typical High $1,995.26 | Professional | 50 · Both sides | $912.01 | $1,174.90 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $125.89 Typical High $213.80 | Professional | 80 · Assistant surgeon | $95.50 | $125.89 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $109.65 Typical High $186.21 | Professional | AS · PA/NP assist | $85.11 | $109.65 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $14,125.38 | Facility | None | $676.08 | $1,096.48 | $14,125.38 |
CareSource Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,122.02 | Professional | None | $691.83 | $891.25 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $10,232.93 | Facility | None | $1,202.26 | $1,862.09 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $6,456.54 | Professional | None | $707.95 | $1,000.00 | $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 $741.31 Median $891.25 Typical High $1,318.26 | Professional | None | $741.31 | $891.25 | $1,318.26 |
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 $316.23 Median $363.08 Typical High $467.74 | Professional | 52 · Reduced service | $316.23 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $144.54 Typical High $186.21 | Professional | 53 · Discontinued | $125.89 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $537.03 Typical High $691.83 | Professional | 54 · Surgery only | $478.63 | $537.03 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $107.15 Typical High $138.04 | Professional | 55 · Aftercare only | $95.50 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $72.44 Typical High $93.33 | Professional | 56 · Pre-op care only | $63.10 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $645.65 |
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· 42nd of 51
$813
AK $3,020TX $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.