How much rates vary
Facilitymedian $2,570 · 10th to 90th $832 to $8,511Professionalmedian $832 · 10th to 90th $676 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 $724.44 Median $912.01 Typical High $8,511.38 | Facility | None | $724.44 | $912.01 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,148.15 | Professional | None | $724.44 | $851.14 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $9,332.54 | Facility | None | $1,071.52 | $3,311.31 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,230.27 | Professional | None | $660.69 | $812.83 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $512.86 Typical High $776.25 | Professional | 62 · Two surgeons | $416.87 | $512.86 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $199.53 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $114.82 Typical High $173.78 | Professional | AS · PA/NP assist | $93.33 | $114.82 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $1,258.93 Typical High $7,413.10 | Facility | None | $776.25 | $1,258.93 | $7,413.10 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,318.26 | Professional | None | $724.44 | $1,047.13 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $2,290.87 Typical High $5,623.41 | Facility | None | $977.24 | $2,290.87 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $6,165.95 | Professional | None | $812.83 | $1,023.29 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $389.05 | Professional | None | $33.11 | $33.11 | $389.05 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,479.11 | Professional | None | $758.58 | $954.99 | $1,479.11 |
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 $363.08 Median $426.58 Typical High $549.54 | Professional | 52 · Reduced service | $363.08 | $426.58 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $223.87 | Professional | 53 · Discontinued | $144.54 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $630.96 Typical High $831.76 | Professional | 54 · Surgery only | $549.54 | $630.96 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $125.89 Typical High $165.96 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $112.20 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $588.84 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $512.86 | $588.84 | $776.25 |
Where Kentucky sits
The same service costs 4.5 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $12,963MT $2,892
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.