How much rates vary
Facilitymedian $1,995 · 10th to 90th $851 to $8,128Professionalmedian $891 · 10th to 90th $708 to $1,479
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 $1,071.52 Typical High $2,630.27 | Facility | None | $794.33 | $1,071.52 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,096.48 | Professional | None | $851.14 | $977.24 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,288.25 | Professional | None | $707.95 | $870.96 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,288.25 Typical High $1,949.84 | Professional | 50 · Both sides | $1,071.52 | $1,288.25 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $138.04 Typical High $208.93 | Professional | 80 · Assistant surgeon | $114.82 | $138.04 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $120.23 Typical High $181.97 | Professional | AS · PA/NP assist | $100.00 | $120.23 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $2,691.53 | Facility | None | $912.01 | $1,479.11 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,479.11 | Professional | None | $933.25 | $1,230.27 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,862.09 Typical High $1,995.26 | Facility | None | $1,122.02 | $1,862.09 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $5,754.40 | Professional | None | $933.25 | $1,258.93 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $489.78 | Professional | None | $33.11 | $33.11 | $489.78 |
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 $776.25 Median $1,174.90 Typical High $1,862.09 | Professional | None | $776.25 | $1,174.90 | $1,862.09 |
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 $426.58 Median $489.78 Typical High $549.54 | Professional | 52 · Reduced service | $426.58 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $194.98 Typical High $218.78 | Professional | 53 · Discontinued | $169.82 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $812.83 | Professional | 54 · Surgery only | $645.65 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $97.72 Typical High $109.65 | Professional | 56 · Pre-op care only | $85.11 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $758.58 |
Where Kentucky sits
The same service costs 7.6 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
$933
AK $3,981TX $525
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.