How much rates vary
Facilitymedian $1,995 · 10th to 90th $776 to $8,128Professionalmedian $813 · 10th to 90th $646 to $1,259
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 $707.95 Median $870.96 Typical High $2,630.27 | Facility | None | $707.95 | $870.96 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $977.24 | Professional | None | $707.95 | $812.83 | $977.24 |
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 $616.60 Median $776.25 Typical High $1,174.90 | Professional | None | $616.60 | $776.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $489.78 Typical High $741.31 | Professional | 62 · Two surgeons | $389.05 | $489.78 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $123.03 Typical High $186.21 | Professional | 80 · Assistant surgeon | $100.00 | $123.03 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $109.65 Typical High $165.96 | Professional | AS · PA/NP assist | $87.10 | $109.65 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $1,230.27 Typical High $2,691.53 | Facility | None | $741.31 | $1,230.27 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,258.93 | Professional | None | $831.76 | $1,023.29 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $1,995.26 | Facility | None | $1,412.54 | $1,862.09 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $5,248.07 | Professional | None | $776.25 | $977.24 | $5,248.07 |
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 $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 $724.44 Median $912.01 Typical High $1,412.54 | Professional | None | $724.44 | $912.01 | $1,412.54 |
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 $346.74 Median $407.38 Typical High $489.78 | Professional | 52 · Reduced service | $346.74 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $162.18 Typical High $194.98 | Professional | 53 · Discontinued | $141.25 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $602.56 Typical High $741.31 | Professional | 54 · Surgery only | $524.81 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $120.23 Typical High $147.91 | Professional | 55 · Aftercare only | $104.71 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $81.28 Typical High $97.72 | Professional | 56 · Pre-op care only | $70.79 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $562.34 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $489.78 | $562.34 | $691.83 |
Where Kentucky sits
The same service costs 7.4 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
$832
AK $3,467TX $468
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.