How much rates vary
Facilitymedian $2,399 · 10th to 90th $794 to $10,000Professionalmedian $1,445 · 10th to 90th $1,072 to $2,188
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 $891.25 Median $1,584.89 Typical High $8,511.38 | Facility | None | $891.25 | $1,584.89 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,479.11 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,318.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,949.84 Typical High $2,884.03 | Professional | 50 · Both sides | $1,621.81 | $1,949.84 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $309.03 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $181.97 Typical High $269.15 | Professional | AS · PA/NP assist | $151.36 | $181.97 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $2,691.53 | Facility | None | $1,380.38 | $2,041.74 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,548.82 | $1,905.46 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,511.89 | Facility | None | $1,698.24 | $1,995.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $8,317.64 | Professional | None | $1,412.54 | $1,778.28 | $8,317.64 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $812.83 | Professional | None | $33.11 | $33.11 | $812.83 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,584.89 | $2,630.27 |
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 $645.65 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $295.12 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $147.91 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $1,047.13 | $1,122.02 |
Where Kentucky sits
The same service costs 15.8 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· 45th of 51
$1,445
AK $6,310TX $398
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.