How much rates vary
Facilitymedian $1,905 · 10th to 90th $794 to $8,511Professionalmedian $1,698 · 10th to 90th $1,380 to $2,570
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 $1,737.80 Typical High $8,511.38 | Facility | None | $891.25 | $1,737.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,584.89 | $2,041.74 |
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 $1,698.24 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,698.24 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,570.40 Typical High $3,548.13 | Professional | 50 · Both sides | $2,041.74 | $2,570.40 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,071.52 Typical High $1,479.11 | Professional | 62 · Two surgeons | $851.14 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $269.15 Typical High $380.19 | Professional | 80 · Assistant surgeon | $218.78 | $269.15 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $239.88 Typical High $331.13 | Professional | AS · PA/NP assist | $190.55 | $239.88 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,454.71 | Facility | None | $1,288.25 | $1,548.82 | $2,454.71 |
CareSource Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,479.11 | $1,995.26 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,630.27 Typical High $5,888.44 | Facility | None | $34.67 | $2,630.27 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $10,000.00 | Professional | None | $1,548.82 | $1,995.26 | $10,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $831.76 | Professional | None | $33.11 | $33.11 | $831.76 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,584.89 | $1,949.84 | $2,951.21 |
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 $707.95 Median $794.33 Typical High $954.99 | Professional | 52 · Reduced service | $707.95 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $323.59 Typical High $380.19 | Professional | 53 · Discontinued | $281.84 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,202.26 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,047.13 | $1,202.26 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $288.40 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $158.49 Typical High $190.55 | Professional | 56 · Pre-op care only | $141.25 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,122.02 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $977.24 | $1,122.02 | $1,348.96 |
Where Kentucky sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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 $16,761KY $3,604
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.