How much rates vary
Facilitymedian $2,138 · 10th to 90th $832 to $8,511Professionalmedian $1,585 · 10th to 90th $1,202 to $2,754
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 $1,737.80 Typical High $8,511.38 | Facility | None | $891.25 | $1,737.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,698.24 | $1,905.46 | $2,137.96 |
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 $1,258.93 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,513.56 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,238.72 Typical High $2,754.23 | Professional | 50 · Both sides | $1,862.09 | $2,238.72 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $954.99 Typical High $1,174.90 | Professional | 62 · Two surgeons | $794.33 | $954.99 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $295.12 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $208.93 Typical High $257.04 | Professional | AS · PA/NP assist | $173.78 | $208.93 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $3,019.95 | Facility | None | $1,621.81 | $1,949.84 | $3,019.95 |
CareSource Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $3,090.30 | Professional | None | $1,862.09 | $2,570.40 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $3,235.94 Typical High $4,466.84 | Facility | None | $34.67 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $2,398.83 Typical High $8,912.51 | Professional | None | $1,318.26 | $2,398.83 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $501.19 | Professional | None | $33.11 | $33.11 | $501.19 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $977.24 Median $2,041.74 Typical High $3,630.78 | Professional | None | $977.24 | $2,041.74 | $3,630.78 |
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 $851.14 Median $954.99 Typical High $1,071.52 | Professional | 52 · Reduced service | $851.14 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $380.19 Typical High $436.52 | Professional | 53 · Discontinued | $338.84 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,412.54 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,288.25 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $281.84 Typical High $323.59 | Professional | 55 · Aftercare only | $257.04 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $190.55 Typical High $213.80 | Professional | 56 · Pre-op care only | $169.82 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,318.26 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,318.26 | $1,513.56 |
Where Kentucky sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $18,090KY $3,723
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.