How much rates vary
Facilitymedian $1,820 · 10th to 90th $794 to $4,266Professionalmedian $1,585 · 10th to 90th $1,259 to $2,455
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 $794.33 Median $1,698.24 Typical High $5,248.07 | Facility | None | $794.33 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,584.89 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,548.82 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,290.87 Typical High $3,388.44 | Professional | 50 · Both sides | $1,905.46 | $2,290.87 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $245.47 Typical High $363.08 | Professional | 80 · Assistant surgeon | $204.17 | $245.47 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $213.80 Typical High $316.23 | Professional | AS · PA/NP assist | $177.83 | $213.80 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $2,691.53 | Facility | None | $1,479.11 | $2,041.74 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,949.84 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,691.53 | Facility | None | $1,584.89 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $12,022.64 | Professional | None | $1,548.82 | $1,905.46 | $12,022.64 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $954.99 | Professional | None | $33.11 | $33.11 | $954.99 |
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 $1,380.38 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,819.70 | $2,818.38 |
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 $691.83 Median $794.33 Typical High $1,047.13 | Professional | 52 · Reduced service | $691.83 | $794.33 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $316.23 Typical High $416.87 | Professional | 53 · Discontinued | $275.42 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,202.26 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,047.13 | $1,202.26 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $309.03 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $208.93 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,122.02 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $977.24 | $1,122.02 | $1,445.44 |
Where Kentucky sits
The same service costs 7.8 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· 44th of 51
$1,585
AK $6,761TX $871
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.