How much rates vary
Facilitymedian $1,995 · 10th to 90th $794 to $8,128Professionalmedian $871 · 10th to 90th $708 to $1,380
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 $776.25 Median $954.99 Typical High $2,630.27 | Facility | None | $776.25 | $954.99 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,122.02 | Professional | None | $776.25 | $891.25 | $1,122.02 |
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 $707.95 Median $851.14 Typical High $1,288.25 | Professional | None | $707.95 | $851.14 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $537.03 Typical High $812.83 | Professional | 62 · Two surgeons | $446.68 | $537.03 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $138.04 Typical High $204.17 | Professional | 80 · Assistant surgeon | $112.20 | $138.04 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $120.23 Typical High $181.97 | Professional | AS · PA/NP assist | $97.72 | $120.23 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $1,348.96 Typical High $2,691.53 | Facility | None | $831.76 | $1,348.96 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,348.96 | Professional | None | $831.76 | $1,096.48 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,819.70 Typical High $1,995.26 | Facility | None | $954.99 | $1,819.70 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $6,025.60 | Professional | None | $870.96 | $1,096.48 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $416.87 | Professional | None | $33.11 | $33.11 | $416.87 |
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 $794.33 Median $1,000.00 Typical High $1,548.82 | Professional | None | $794.33 | $1,000.00 | $1,548.82 |
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 $389.05 Median $446.68 Typical High $562.34 | Professional | 52 · Reduced service | $389.05 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $177.83 Typical High $229.09 | Professional | 53 · Discontinued | $154.88 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $676.08 Typical High $851.14 | Professional | 54 · Surgery only | $575.44 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $169.82 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $89.13 Typical High $112.20 | Professional | 56 · Pre-op care only | $77.62 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $794.33 |
Where Kentucky sits
The same service costs 3.1 times more in Alaska than in Hawaii. 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 $8,167HI $2,648
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.