How much rates vary
Facilitymedian $1,950 · 10th to 90th $851 to $11,482Professionalmedian $1,549 · 10th to 90th $1,202 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 $1,000.00 Median $1,737.80 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,737.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,584.89 | $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 $1,202.26 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,445.44 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,187.76 Typical High $2,884.03 | Professional | 50 · Both sides | $1,778.28 | $2,187.76 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $912.01 Typical High $1,230.27 | Professional | 62 · Two surgeons | $758.58 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $229.09 Typical High $316.23 | Professional | 80 · Assistant surgeon | $190.55 | $229.09 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $204.17 Typical High $269.15 | Professional | AS · PA/NP assist | $165.96 | $204.17 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,398.83 | Facility | None | $1,288.25 | $1,548.82 | $2,398.83 |
CareSource Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,659.59 | $2,041.74 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,570.40 Typical High $11,481.54 | Facility | None | $34.67 | $2,570.40 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $10,232.93 | Professional | None | $1,548.82 | $1,995.26 | $10,232.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $724.44 | Professional | None | $33.11 | $33.11 | $724.44 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,162.28 Typical High $12,302.69 | Facility | None | $1,148.15 | $3,162.28 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,949.84 | $2,884.03 |
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 $691.83 Median $794.33 Typical High $977.24 | Professional | 52 · Reduced service | $691.83 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $389.05 | Professional | 53 · Discontinued | $281.84 | $316.23 | $389.05 |
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 $295.12 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $194.98 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $194.98 |
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 17.0 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· 46th of 51
$1,549
AK $6,607TX $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.