How much rates vary
Facilitymedian $2,239 · 10th to 90th $776 to $8,318Professionalmedian $813 · 10th to 90th $661 to $1,288
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 $891.25 Typical High $2,630.27 | Facility | None | $707.95 | $891.25 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,071.52 | Professional | None | $707.95 | $831.76 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,709.64 | Facility | None | $954.99 | $2,884.03 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,174.90 | Professional | None | $645.65 | $794.33 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $501.19 Typical High $741.31 | Professional | 62 · Two surgeons | $407.38 | $501.19 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $128.82 Typical High $190.55 | Professional | 80 · Assistant surgeon | $104.71 | $128.82 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $112.20 Typical High $165.96 | Professional | AS · PA/NP assist | $91.20 | $112.20 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $1,258.93 Typical High $8,128.31 | Facility | None | $758.58 | $1,258.93 | $8,128.31 |
CareSource Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,288.25 | Professional | None | $851.14 | $1,047.13 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,862.09 Typical High $6,165.95 | Facility | None | $891.25 | $1,862.09 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $5,754.40 | Professional | None | $794.33 | $1,000.00 | $5,754.40 |
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 $741.31 Median $933.25 Typical High $1,445.44 | Professional | None | $741.31 | $933.25 | $1,445.44 |
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 $354.81 Median $416.87 Typical High $537.03 | Professional | 52 · Reduced service | $354.81 | $416.87 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $165.96 Typical High $218.78 | Professional | 53 · Discontinued | $144.54 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $616.60 Typical High $812.83 | Professional | 54 · Surgery only | $537.03 | $616.60 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $123.03 Typical High $162.18 | Professional | 55 · Aftercare only | $107.15 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $83.18 Typical High $107.15 | Professional | 56 · Pre-op care only | $70.79 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $575.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $501.19 | $575.44 | $758.58 |
Where Kentucky sits
The same service costs 7.6 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· 43rd of 51
$851
AK $3,548TX $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.