How much rates vary
Facilitymedian $1,660 · 10th to 90th $832 to $8,913Professionalmedian $1,202 · 10th to 90th $977 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 $1,288.25 Typical High $8,511.38 | Facility | None | $891.25 | $1,288.25 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,174.90 | $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 $977.24 Median $1,202.26 Typical High $1,698.24 | Professional | None | $977.24 | $1,202.26 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,778.28 Typical High $2,511.89 | Professional | 50 · Both sides | $1,479.11 | $1,778.28 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $758.58 Typical High $1,071.52 | Professional | 62 · Two surgeons | $616.60 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $194.98 Typical High $269.15 | Professional | 80 · Assistant surgeon | $154.88 | $194.98 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $169.82 Typical High $234.42 | Professional | AS · PA/NP assist | $138.04 | $169.82 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,819.70 | Facility | None | $954.99 | $1,148.15 | $1,819.70 |
CareSource Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,513.56 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,949.84 Typical High $5,754.40 | Facility | None | $34.67 | $1,949.84 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $7,585.78 | Professional | None | $1,148.15 | $1,445.44 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $501.19 | Professional | None | $33.11 | $33.11 | $501.19 |
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 $1,122.02 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,412.54 | $2,137.96 |
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 $512.86 Median $588.84 Typical High $724.44 | Professional | 52 · Reduced service | $512.86 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $234.42 Typical High $288.40 | Professional | 53 · Discontinued | $208.93 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $891.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $776.25 | $891.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $177.83 Typical High $213.80 | Professional | 55 · Aftercare only | $154.88 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $117.49 Typical High $144.54 | Professional | 56 · Pre-op care only | $102.33 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $831.76 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $724.44 | $831.76 | $1,000.00 |
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· 43rd of 51
$1,230
AK $5,012TX $575
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.