How much rates vary
Facilitymedian $1,660 · 10th to 90th $501 to $4,365Professionalmedian $501 · 10th to 90th $398 to $1,148
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 $407.38 Median $501.19 Typical High $5,248.07 | Facility | None | $407.38 | $501.19 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $794.33 | Professional | None | $407.38 | $457.09 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $1,148.15 | Professional | None | $389.05 | $501.19 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $245.47 Median $316.23 Typical High $724.44 | Professional | 62 · Two surgeons | $245.47 | $316.23 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $79.43 Typical High $186.21 | Professional | 80 · Assistant surgeon | $63.10 | $79.43 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $69.18 Typical High $162.18 | Professional | AS · PA/NP assist | $54.95 | $69.18 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $5,888.44 | Facility | None | $436.52 | $707.95 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $724.44 | Professional | None | $398.11 | $588.84 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,659.59 Typical High $4,365.16 | Facility | None | $537.03 | $1,659.59 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $4,677.35 | Professional | None | $446.68 | $616.60 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $281.84 | Professional | None | $33.11 | $33.11 | $281.84 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $851.14 | Professional | None | $457.09 | $575.44 | $851.14 |
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 $204.17 Median $229.09 Typical High $302.00 | Professional | 52 · Reduced service | $204.17 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $91.20 Typical High $120.23 | Professional | 53 · Discontinued | $81.28 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $346.74 Typical High $446.68 | Professional | 54 · Surgery only | $302.00 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $69.18 Typical High $89.13 | Professional | 55 · Aftercare only | $60.26 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $45.71 Typical High $60.26 | Professional | 56 · Pre-op care only | $40.74 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $323.59 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $281.84 | $323.59 | $416.87 |
Where Kentucky sits
The same service costs 7.0 times more in Alabama than in Montana. 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
AL $10,808MT $1,535
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.