How much rates vary
Facilitymedian $1,288 · 10th to 90th $603 to $7,943Professionalmedian $741 · 10th to 90th $589 to $1,230
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 $602.56 Median $741.31 Typical High $1,047.13 | Facility | None | $602.56 | $741.31 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $891.25 | Professional | None | $602.56 | $691.83 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,230.27 | Professional | None | $575.44 | $724.44 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,096.48 Typical High $1,862.09 | Professional | 50 · Both sides | $851.14 | $1,096.48 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $117.49 Typical High $199.53 | Professional | 80 · Assistant surgeon | $91.20 | $117.49 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $102.33 Typical High $173.78 | Professional | AS · PA/NP assist | $79.43 | $102.33 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $660.69 Typical High $1,047.13 | Facility | None | $549.54 | $660.69 | $1,047.13 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,071.52 | Professional | None | $724.44 | $870.96 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,148.15 Typical High $4,466.84 | Facility | None | $34.67 | $1,148.15 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $5,495.41 | Professional | None | $660.69 | $891.25 | $5,495.41 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $363.08 | Professional | None | $33.11 | $33.11 | $363.08 |
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 $691.83 Median $831.76 Typical High $1,230.27 | Professional | None | $691.83 | $831.76 | $1,230.27 |
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 $302.00 Median $338.84 Typical High $446.68 | Professional | 52 · Reduced service | $302.00 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $138.04 Typical High $177.83 | Professional | 53 · Discontinued | $120.23 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $512.86 Typical High $660.69 | Professional | 54 · Surgery only | $446.68 | $512.86 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $102.33 Typical High $131.83 | Professional | 55 · Aftercare only | $89.13 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $478.63 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $416.87 | $478.63 | $616.60 |
Where Kentucky sits
The same service costs 8.7 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
$741
AK $2,884TX $331
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.