How much rates vary
Facilitymedian $1,288 · 10th to 90th $603 to $7,943Professionalmedian $676 · 10th to 90th $537 to $1,047
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 $851.14 | Facility | None | $602.56 | $741.31 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $851.14 | Professional | None | $602.56 | $691.83 | $851.14 |
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 $537.03 Median $660.69 Typical High $977.24 | Professional | None | $537.03 | $660.69 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,000.00 Typical High $1,479.11 | Professional | 50 · Both sides | $812.83 | $1,000.00 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $107.15 Typical High $154.88 | Professional | 80 · Assistant surgeon | $87.10 | $107.15 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $93.33 Typical High $138.04 | Professional | AS · PA/NP assist | $75.86 | $93.33 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $1,047.13 | Facility | None | $562.34 | $676.08 | $1,047.13 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,071.52 | Professional | None | $602.56 | $891.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,174.90 Typical High $1,949.84 | Facility | None | $34.67 | $1,174.90 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $4,466.84 | Professional | None | $676.08 | $812.83 | $4,466.84 |
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 $616.60 Median $741.31 Typical High $1,202.26 | Professional | None | $616.60 | $741.31 | $1,202.26 |
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 $302.00 Median $346.74 Typical High $426.58 | Professional | 52 · Reduced service | $302.00 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $138.04 Typical High $169.82 | Professional | 53 · Discontinued | $120.23 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $630.96 | Professional | 54 · Surgery only | $457.09 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $125.89 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $478.63 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $426.58 | $478.63 | $588.84 |
Where Kentucky sits
The same service costs 19.5 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· 45th of 51
$676
AK $2,951TX $151
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.