How much rates vary
Facilitymedian $1,905 · 10th to 90th $851 to $11,220Professionalmedian $1,622 · 10th to 90th $1,318 to $2,512
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 $1,380.38 Median $1,698.24 Typical High $1,905.46 | Facility | None | $1,380.38 | $1,698.24 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,584.89 | $1,905.46 |
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 $1,318.26 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,584.89 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,000.00 Typical High $1,513.56 | Professional | 62 · Two surgeons | $831.76 | $1,000.00 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $257.04 Typical High $389.05 | Professional | 80 · Assistant surgeon | $208.93 | $257.04 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $223.87 Typical High $338.84 | Professional | AS · PA/NP assist | $181.97 | $223.87 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,398.83 | Facility | None | $1,288.25 | $1,513.56 | $2,398.83 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,348.96 | $2,041.74 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,570.40 Typical High $10,964.78 | Facility | None | $34.67 | $2,570.40 | $10,964.78 |
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 $1,122.02 | Professional | None | $33.11 | $33.11 | $1,122.02 |
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 $1,513.56 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,513.56 | $1,862.09 | $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 $954.99 | Professional | 52 · Reduced service | $691.83 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $316.23 Typical High $380.19 | Professional | 53 · Discontinued | $275.42 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,174.90 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,023.29 | $1,174.90 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $281.84 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $190.55 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,096.48 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $954.99 | $1,096.48 | $1,318.26 |
Where Kentucky sits
The same service costs 20.4 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
$1,622
AK $6,607TX $324
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.