How much rates vary
Facilitymedian $2,089 · 10th to 90th $724 to $7,586Professionalmedian $661 · 10th to 90th $513 to $1,072
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 $588.84 Median $741.31 Typical High $2,630.27 | Facility | None | $588.84 | $741.31 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $831.76 | Professional | None | $588.84 | $676.08 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $1,023.29 | Professional | None | $512.86 | $630.96 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $933.25 Typical High $1,513.56 | Professional | 50 · Both sides | $776.25 | $933.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $100.00 Typical High $162.18 | Professional | 80 · Assistant surgeon | $83.18 | $100.00 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $87.10 Typical High $141.25 | Professional | AS · PA/NP assist | $72.44 | $87.10 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $1,023.29 Typical High $3,467.37 | Facility | None | $549.54 | $1,023.29 | $3,467.37 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,023.29 | Professional | None | $645.65 | $851.14 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,862.09 Typical High $2,570.40 | Facility | None | $707.95 | $1,862.09 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $4,365.16 | Professional | None | $660.69 | $812.83 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $371.54 | Professional | None | $33.11 | $33.11 | $371.54 |
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 $588.84 Median $776.25 Typical High $1,202.26 | Professional | None | $588.84 | $776.25 | $1,202.26 |
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 $295.12 Median $338.84 Typical High $416.87 | Professional | 52 · Reduced service | $295.12 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $134.90 Typical High $165.96 | Professional | 53 · Discontinued | $120.23 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $512.86 Typical High $616.60 | Professional | 54 · Surgery only | $446.68 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $102.33 Typical High $123.03 | Professional | 55 · Aftercare only | $89.13 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $67.61 Typical High $83.18 | Professional | 56 · Pre-op care only | $58.88 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $478.63 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $416.87 | $478.63 | $575.44 |
Where Kentucky sits
The same service costs 8.5 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· 44th of 51
$708
AK $2,884TX $339
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.