How much rates vary
Facilitymedian $1,820 · 10th to 90th $832 to $8,710Professionalmedian $1,660 · 10th to 90th $1,349 to $2,570
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 $794.33 Median $1,737.80 Typical High $2,630.27 | Facility | None | $794.33 | $1,737.80 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,584.89 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,332.54 Typical High $11,220.18 | Facility | None | $758.58 | $9,332.54 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,348.96 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,511.89 Typical High $3,388.44 | Professional | 50 · Both sides | $2,041.74 | $2,511.89 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,047.13 Typical High $1,412.54 | Professional | 62 · Two surgeons | $851.14 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $269.15 Typical High $354.81 | Professional | 80 · Assistant surgeon | $218.78 | $269.15 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $234.42 Typical High $316.23 | Professional | AS · PA/NP assist | $190.55 | $234.42 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,479.11 Median $2,454.71 Typical High $5,888.44 | Facility | None | $1,479.11 | $2,454.71 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,380.38 | $2,041.74 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,630.27 Typical High $4,466.84 | Facility | None | $34.67 | $2,630.27 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $9,332.54 | Professional | None | $1,548.82 | $1,949.84 | $9,332.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $912.01 | Professional | None | $33.11 | $33.11 | $912.01 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,584.89 | $1,905.46 | $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 $707.95 Median $794.33 Typical High $912.01 | Professional | 52 · Reduced service | $707.95 | $794.33 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $363.08 | Professional | 53 · Discontinued | $281.84 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,202.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,047.13 | $1,202.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $158.49 Typical High $181.97 | Professional | 56 · Pre-op care only | $141.25 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,122.02 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $977.24 | $1,122.02 | $1,258.93 |
Where Kentucky sits
The same service costs 7.8 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
$1,698
AK $6,761TX $871
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.