How much rates vary
Facilitymedian $1,549 · 10th to 90th $794 to $8,511Professionalmedian $1,230 · 10th to 90th $977 to $1,950
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 $1,258.93 Typical High $8,511.38 | Facility | None | $891.25 | $1,258.93 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,148.15 | $1,548.82 |
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 $977.24 Median $1,230.27 Typical High $1,862.09 | Professional | None | $977.24 | $1,230.27 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,862.09 Typical High $2,818.38 | Professional | 50 · Both sides | $1,479.11 | $1,862.09 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $776.25 Typical High $1,174.90 | Professional | 62 · Two surgeons | $616.60 | $776.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $199.53 Typical High $302.00 | Professional | 80 · Assistant surgeon | $158.49 | $199.53 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $173.78 Typical High $263.03 | Professional | AS · PA/NP assist | $138.04 | $173.78 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,737.80 | Facility | None | $933.25 | $1,122.02 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,479.11 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,862.09 Typical High $5,623.41 | Facility | None | $34.67 | $1,862.09 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $8,128.31 | Professional | None | $1,122.02 | $1,513.56 | $8,128.31 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,412.54 | $2,089.30 |
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 $501.19 Median $575.44 Typical High $741.31 | Professional | 52 · Reduced service | $501.19 | $575.44 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $229.09 Typical High $295.12 | Professional | 53 · Discontinued | $204.17 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $870.96 Typical High $1,122.02 | Professional | 54 · Surgery only | $758.58 | $870.96 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $173.78 Typical High $223.87 | Professional | 55 · Aftercare only | $151.36 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $114.82 Typical High $147.91 | Professional | 56 · Pre-op care only | $100.00 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $812.83 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $707.95 | $812.83 | $1,047.13 |
Where Kentucky sits
The same service costs 8.7 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
$1,259
AK $4,786TX $550
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.