How much rates vary
Facilitymedian $1,778 · 10th to 90th $832 to $8,913Professionalmedian $1,479 · 10th to 90th $1,202 to $2,344
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 $1,548.82 Typical High $8,511.38 | Facility | None | $891.25 | $1,548.82 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,412.54 | $1,778.28 |
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 $1,202.26 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,479.11 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,187.76 Typical High $3,235.94 | Professional | 50 · Both sides | $1,819.70 | $2,187.76 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $933.25 Typical High $1,348.96 | Professional | 62 · Two surgeons | $758.58 | $933.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $234.42 Typical High $346.74 | Professional | 80 · Assistant surgeon | $190.55 | $234.42 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $208.93 Typical High $302.00 | Professional | AS · PA/NP assist | $169.82 | $208.93 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,137.96 | Facility | None | $1,148.15 | $1,380.38 | $2,137.96 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,737.80 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,344.23 Typical High $5,623.41 | Facility | None | $34.67 | $2,344.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $9,332.54 | Professional | None | $1,380.38 | $1,737.80 | $9,332.54 |
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 $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 $1,412.54 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,698.24 | $2,570.40 |
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 $616.60 Median $707.95 Typical High $891.25 | Professional | 52 · Reduced service | $616.60 | $707.95 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $281.84 Typical High $354.81 | Professional | 53 · Discontinued | $251.19 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,071.52 Typical High $1,318.26 | Professional | 54 · Surgery only | $933.25 | $1,071.52 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $213.80 Typical High $269.15 | Professional | 55 · Aftercare only | $186.21 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $141.25 Typical High $177.83 | Professional | 56 · Pre-op care only | $123.03 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,000.00 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $870.96 | $1,000.00 | $1,230.27 |
Where Kentucky sits
The same service costs 8.7 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
$1,479
AK $5,888TX $676
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.