How much rates vary
Facilitymedian $2,570 · 10th to 90th $724 to $8,511Professionalmedian $646 · 10th to 90th $525 to $1,023
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 $549.54 Median $676.08 Typical High $8,511.38 | Facility | None | $549.54 | $676.08 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $912.01 | Professional | None | $549.54 | $630.96 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $954.99 | Professional | None | $524.81 | $645.65 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $954.99 Typical High $1,445.44 | Professional | 50 · Both sides | $776.25 | $954.99 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $407.38 Typical High $602.56 | Professional | 62 · Two surgeons | $331.13 | $407.38 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $102.33 Typical High $154.88 | Professional | 80 · Assistant surgeon | $83.18 | $102.33 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $89.13 Typical High $134.90 | Professional | AS · PA/NP assist | $72.44 | $89.13 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $7,585.78 | Facility | None | $512.86 | $954.99 | $7,585.78 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $954.99 | Professional | None | $549.54 | $776.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,290.87 Typical High $6,606.93 | Facility | None | $724.44 | $2,290.87 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $4,168.69 | Professional | None | $616.60 | $776.25 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $389.05 | Professional | None | $33.11 | $33.11 | $389.05 |
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 $602.56 Median $741.31 Typical High $1,122.02 | Professional | None | $602.56 | $741.31 | $1,122.02 |
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 $275.42 Median $316.23 Typical High $398.11 | Professional | 52 · Reduced service | $275.42 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $125.89 Typical High $158.49 | Professional | 53 · Discontinued | $109.65 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $588.84 | Professional | 54 · Surgery only | $416.87 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $95.50 Typical High $117.49 | Professional | 55 · Aftercare only | $83.18 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $63.10 Typical High $79.43 | Professional | 56 · Pre-op care only | $54.95 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $549.54 |
Where Kentucky sits
The same service costs 5.4 times more in Alaska than in Montana. 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 $11,142MT $2,070
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.