How much rates vary
Facilitymedian $2,570 · 10th to 90th $871 to $8,511Professionalmedian $977 · 10th to 90th $794 to $1,479
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 $851.14 Median $1,071.52 Typical High $8,511.38 | Facility | None | $851.14 | $1,071.52 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,096.48 | Professional | None | $870.96 | $1,000.00 | $1,096.48 |
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 $794.33 Median $933.25 Typical High $1,202.26 | Professional | None | $794.33 | $933.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,412.54 Typical High $1,819.70 | Professional | 50 · Both sides | $1,174.90 | $1,412.54 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $151.36 Typical High $199.53 | Professional | 80 · Assistant surgeon | $125.89 | $151.36 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $131.83 Typical High $169.82 | Professional | AS · PA/NP assist | $109.65 | $131.83 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $1,513.56 Typical High $5,888.44 | Facility | None | $812.83 | $1,513.56 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,288.25 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $4,466.84 | Facility | None | $1,698.24 | $2,290.87 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $5,888.44 | Professional | None | $977.24 | $1,148.15 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $380.19 | Professional | None | $33.11 | $33.11 | $380.19 |
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 $870.96 Median $1,122.02 Typical High $1,737.80 | Professional | None | $870.96 | $1,122.02 | $1,737.80 |
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 $436.52 Median $501.19 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $199.53 Typical High $218.78 | Professional | 53 · Discontinued | $173.78 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $741.31 Typical High $831.76 | Professional | 54 · Surgery only | $645.65 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $165.96 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $100.00 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $691.83 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $602.56 | $691.83 | $776.25 |
Where Kentucky sits
The same service costs 3.9 times more in Alaska than in Delaware. 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 $12,209DE $3,093
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.