How much rates vary
Facilitymedian $1,660 · 10th to 90th $692 to $7,943Professionalmedian $1,622 · 10th to 90th $1,318 to $2,512
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 $1,659.59 Typical High $2,630.27 | Facility | None | $794.33 | $1,659.59 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,548.82 | $1,995.26 |
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 $1,318.26 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,584.89 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,398.83 Typical High $3,388.44 | Professional | 50 · Both sides | $1,949.84 | $2,398.83 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,023.29 Typical High $1,445.44 | Professional | 62 · Two surgeons | $831.76 | $1,023.29 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $257.04 Typical High $363.08 | Professional | 80 · Assistant surgeon | $208.93 | $257.04 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $223.87 Typical High $316.23 | Professional | AS · PA/NP assist | $181.97 | $223.87 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,344.23 | Facility | None | $1,258.93 | $1,513.56 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,479.11 | $1,905.46 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,511.89 Typical High $8,128.31 | Facility | None | $34.67 | $2,511.89 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $9,120.11 | Professional | None | $1,513.56 | $1,905.46 | $9,120.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $933.25 | Professional | None | $33.11 | $33.11 | $933.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,862.09 | $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 $676.08 Median $776.25 Typical High $870.96 | Professional | 52 · Reduced service | $676.08 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $309.03 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,148.15 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,023.29 | $1,148.15 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $229.09 Typical High $263.03 | Professional | 55 · Aftercare only | $204.17 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $154.88 Typical High $173.78 | Professional | 56 · Pre-op care only | $134.90 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,071.52 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $954.99 | $1,071.52 | $1,230.27 |
Where Kentucky sits
The same service costs 6.3 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.
Physician feeFacility fee
AK $16,928TX $2,675
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.