How much rates vary
Facilitymedian $2,089 · 10th to 90th $832 to $8,511Professionalmedian $1,778 · 10th to 90th $1,380 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 $1,778.28 Typical High $8,511.38 | Facility | None | $891.25 | $1,778.28 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,659.59 | $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 $1,380.38 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,737.80 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,630.27 Typical High $3,801.89 | Professional | 50 · Both sides | $2,089.30 | $2,630.27 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,096.48 Typical High $1,698.24 | Professional | 62 · Two surgeons | $870.96 | $1,096.48 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $281.84 Typical High $407.38 | Professional | 80 · Assistant surgeon | $223.87 | $281.84 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $245.47 Typical High $354.81 | Professional | AS · PA/NP assist | $194.98 | $245.47 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,511.89 | Facility | None | $1,348.96 | $1,621.81 | $2,511.89 |
CareSource Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $2,570.40 | Professional | None | $1,548.82 | $2,137.96 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,691.53 Typical High $5,623.41 | Facility | None | $34.67 | $2,691.53 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $10,964.78 | Professional | None | $1,621.81 | $2,041.74 | $10,964.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $912.01 | Professional | None | $33.11 | $33.11 | $912.01 |
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 $1,621.81 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,621.81 | $1,995.26 | $3,019.95 |
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 $724.44 Median $831.76 Typical High $1,047.13 | Professional | 52 · Reduced service | $724.44 | $831.76 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $331.13 Typical High $416.87 | Professional | 53 · Discontinued | $288.40 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,230.27 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,096.48 | $1,230.27 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $245.47 Typical High $309.03 | Professional | 55 · Aftercare only | $218.78 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $165.96 Typical High $208.93 | Professional | 56 · Pre-op care only | $144.54 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,148.15 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,148.15 | $1,445.44 |
Where Kentucky sits
The same service costs 9.3 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.
Kentucky· 42nd of 51
$1,778
AK $6,918TX $741
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.