How much rates vary
Facilitymedian $3,236 · 10th to 90th $759 to $6,761Professionalmedian $3,548 · 10th to 90th $2,818 to $5,888
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 $3,981.07 Typical High $8,511.38 | Facility | None | $851.14 | $3,981.07 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,715.35 Typical High $3,981.07 | Professional | None | $3,235.94 | $3,715.35 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $3,548.13 Typical High $5,370.32 | Professional | None | $2,754.23 | $3,548.13 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,073.80 Median $5,248.07 Typical High $8,128.31 | Professional | 50 · Both sides | $4,073.80 | $5,248.07 | $8,128.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $2,187.76 Typical High $3,388.44 | Professional | 62 · Two surgeons | $1,737.80 | $2,187.76 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $562.34 Typical High $851.14 | Professional | 80 · Assistant surgeon | $436.52 | $562.34 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $489.78 Typical High $758.58 | Professional | AS · PA/NP assist | $380.19 | $489.78 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $1,148.15 Typical High $3,981.07 | Facility | None | $707.95 | $1,148.15 | $3,981.07 |
CareSource Setting Professional Modifier None Typical Low $3,801.89 Median $4,677.35 Typical High $5,754.40 | Professional | None | $3,801.89 | $4,677.35 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $5,370.32 Typical High $6,025.60 | Facility | None | $34.67 | $5,370.32 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $4,466.84 Typical High $21,877.62 | Professional | None | $3,548.13 | $4,466.84 | $21,877.62 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $2,344.23 | Professional | None | $33.11 | $33.11 | $2,344.23 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $3,548.13 Median $3,890.45 Typical High $6,606.93 | Professional | None | $3,548.13 | $3,890.45 | $6,606.93 |
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 $1,621.81 Median $1,819.70 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,621.81 | $1,819.70 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $741.31 Typical High $831.76 | Professional | 53 · Discontinued | $645.65 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,754.23 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,398.83 | $2,754.23 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $549.54 Typical High $630.96 | Professional | 55 · Aftercare only | $478.63 | $549.54 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $371.54 Typical High $416.87 | Professional | 56 · Pre-op care only | $323.59 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,570.40 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,570.40 | $2,884.03 |
Where Kentucky sits
The same service costs 20.4 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· 45th of 51
$3,548
AK $15,488TX $759
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.