How much rates vary
Facilitymedian $1,862 · 10th to 90th $832 to $8,511Professionalmedian $1,514 · 10th to 90th $1,230 to $2,455
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 $1,659.59 Typical High $8,511.38 | Facility | None | $891.25 | $1,659.59 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,548.82 | $1,949.84 |
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 $1,230.27 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,479.11 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,238.72 Typical High $3,548.13 | Professional | 50 · Both sides | $1,819.70 | $2,238.72 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $1,479.11 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $239.88 Typical High $380.19 | Professional | 80 · Assistant surgeon | $194.98 | $239.88 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $208.93 Typical High $331.13 | Professional | AS · PA/NP assist | $169.82 | $208.93 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,344.23 | Facility | None | $1,230.27 | $1,479.11 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,949.84 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,511.89 Typical High $5,623.41 | Facility | None | $34.67 | $2,511.89 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $10,232.93 | Professional | None | $1,479.11 | $1,905.46 | $10,232.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $851.14 | Professional | None | $33.11 | $33.11 | $851.14 |
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 $1,445.44 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,819.70 | $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 $758.58 Typical High $954.99 | Professional | 52 · Reduced service | $676.08 | $758.58 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $309.03 Typical High $389.05 | Professional | 53 · Discontinued | $269.15 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,148.15 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,000.00 | $1,148.15 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $229.09 Typical High $288.40 | Professional | 55 · Aftercare only | $199.53 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $154.88 Typical High $194.98 | Professional | 56 · Pre-op care only | $134.90 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,071.52 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $933.25 | $1,071.52 | $1,348.96 |
Where Kentucky sits
The same service costs 8.9 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
$1,549
AK $6,457TX $724
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.