How much rates vary
Facilitymedian $1,995 · 10th to 90th $759 to $8,128Professionalmedian $708 · 10th to 90th $575 to $1,096
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 $602.56 Median $758.58 Typical High $2,630.27 | Facility | None | $602.56 | $758.58 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $933.25 | Professional | None | $602.56 | $691.83 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,071.52 | Professional | None | $575.44 | $707.95 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $446.68 Typical High $676.08 | Professional | 62 · Two surgeons | $354.81 | $446.68 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $112.20 Typical High $169.82 | Professional | 80 · Assistant surgeon | $91.20 | $112.20 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $97.72 Typical High $151.36 | Professional | AS · PA/NP assist | $79.43 | $97.72 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $2,691.53 | Facility | None | $562.34 | $1,071.52 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,096.48 | Professional | None | $645.65 | $891.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $1,995.26 | Facility | None | $1,174.90 | $1,862.09 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $4,897.79 | Professional | None | $676.08 | $891.25 | $4,897.79 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $380.19 | Professional | None | $33.11 | $33.11 | $380.19 |
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 $645.65 Median $812.83 Typical High $1,230.27 | Professional | None | $645.65 | $812.83 | $1,230.27 |
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 $302.00 Median $346.74 Typical High $446.68 | Professional | 52 · Reduced service | $302.00 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $177.83 | Professional | 53 · Discontinued | $123.03 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $676.08 | Professional | 54 · Surgery only | $457.09 | $524.81 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $134.90 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $489.78 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $426.58 | $489.78 | $630.96 |
Where Kentucky sits
The same service costs 8.5 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· 41st of 51
$759
AK $2,951TX $347
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.