How much rates vary
Facilitymedian $1,660 · 10th to 90th $832 to $8,511Professionalmedian $1,259 · 10th to 90th $1,000 to $2,138
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 $1,380.38 Typical High $8,511.38 | Facility | None | $891.25 | $1,380.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,412.54 | $1,621.81 |
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 $1,000.00 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,230.27 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $2,290.87 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $776.25 Typical High $954.99 | Professional | 62 · Two surgeons | $630.96 | $776.25 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $251.19 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $213.80 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,445.44 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,862.09 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,905.46 Typical High $2,454.71 | Facility | None | $34.67 | $1,905.46 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $7,413.10 | Professional | None | $1,122.02 | $1,778.28 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $524.81 | Professional | None | $33.11 | $33.11 | $524.81 |
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 $933.25 Median $1,548.82 Typical High $2,691.53 | Professional | None | $933.25 | $1,548.82 | $2,691.53 |
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 $645.65 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,122.02 |
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· 46th of 51
$1,259
AK $6,166TX $724
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.