How much rates vary
Facilitymedian $1,622 · 10th to 90th $759 to $7,244Professionalmedian $1,549 · 10th to 90th $1,288 to $2,399
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 $851.14 Median $1,621.81 Typical High $8,511.38 | Facility | None | $851.14 | $1,621.81 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,479.11 | $1,862.09 |
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 $1,288.25 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,548.82 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,290.87 Typical High $3,311.31 | Professional | 50 · Both sides | $1,905.46 | $2,290.87 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $245.47 Typical High $354.81 | Professional | 80 · Assistant surgeon | $204.17 | $245.47 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $218.78 Typical High $309.03 | Professional | AS · PA/NP assist | $177.83 | $218.78 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,445.44 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,862.09 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,344.23 Typical High $2,511.89 | Facility | None | $34.67 | $2,344.23 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $9,772.37 | Professional | None | $1,445.44 | $1,862.09 | $9,772.37 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,479.11 | $1,819.70 | $2,754.23 |
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 $660.69 Median $741.31 Typical High $912.01 | Professional | 52 · Reduced service | $660.69 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $302.00 Typical High $371.54 | Professional | 53 · Discontinued | $263.03 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,122.02 Typical High $1,380.38 | Professional | 54 · Surgery only | $977.24 | $1,122.02 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $223.87 Typical High $275.42 | Professional | 55 · Aftercare only | $194.98 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $186.21 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,047.13 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $912.01 | $1,047.13 | $1,288.25 |
Where Kentucky sits
The same service costs 16.2 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
$1,549
AK $6,310TX $389
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.