How much rates vary
Facilitymedian $1,660 · 10th to 90th $832 to $8,511Professionalmedian $1,148 · 10th to 90th $933 to $1,820
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 $891.25 Median $1,202.26 Typical High $8,511.38 | Facility | None | $891.25 | $1,202.26 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,445.44 | Professional | None | $954.99 | $1,096.48 | $1,445.44 |
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 $912.01 Median $1,148.15 Typical High $1,778.28 | Professional | None | $912.01 | $1,148.15 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,737.80 Typical High $2,630.27 | Professional | 50 · Both sides | $1,380.38 | $1,737.80 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $724.44 Typical High $1,122.02 | Professional | 62 · Two surgeons | $575.44 | $724.44 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $181.97 Typical High $281.84 | Professional | 80 · Assistant surgeon | $147.91 | $181.97 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $162.18 Typical High $245.47 | Professional | AS · PA/NP assist | $128.82 | $162.18 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,659.59 | Facility | None | $891.25 | $1,071.52 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,380.38 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,819.70 Typical High $5,888.44 | Facility | None | $34.67 | $1,819.70 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $7,585.78 | Professional | None | $1,071.52 | $1,412.54 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $741.31 | Professional | None | $33.11 | $33.11 | $741.31 |
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 $1,071.52 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,318.26 | $1,995.26 |
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 $478.63 Median $549.54 Typical High $707.95 | Professional | 52 · Reduced service | $478.63 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $218.78 Typical High $281.84 | Professional | 53 · Discontinued | $190.55 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $831.76 Typical High $1,071.52 | Professional | 54 · Surgery only | $724.44 | $831.76 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $165.96 Typical High $213.80 | Professional | 55 · Aftercare only | $144.54 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $109.65 Typical High $141.25 | Professional | 56 · Pre-op care only | $95.50 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $776.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $676.08 | $776.25 | $1,000.00 |
Where Kentucky sits
The same service costs 5.1 times more in Alaska than in Kentucky. 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 $14,343KY $2,808
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.