How much rates vary
Facilitymedian $1,549 · 10th to 90th $832 to $8,511Professionalmedian $1,023 · 10th to 90th $794 to $1,585
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 $1,096.48 Typical High $8,511.38 | Facility | None | $891.25 | $1,096.48 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,318.26 | Professional | None | $891.25 | $1,000.00 | $1,318.26 |
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 $758.58 Median $1,000.00 Typical High $1,479.11 | Professional | None | $758.58 | $1,000.00 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,513.56 Typical High $2,187.76 | Professional | 50 · Both sides | $1,122.02 | $1,513.56 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $630.96 Typical High $933.25 | Professional | 62 · Two surgeons | $478.63 | $630.96 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $162.18 Typical High $234.42 | Professional | 80 · Assistant surgeon | $123.03 | $162.18 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $141.25 Typical High $204.17 | Professional | AS · PA/NP assist | $104.71 | $141.25 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $977.24 Typical High $1,548.82 | Facility | None | $812.83 | $977.24 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $933.25 | $1,288.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,659.59 Typical High $1,949.84 | Facility | None | $34.67 | $1,659.59 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $6,918.31 | Professional | None | $977.24 | $1,258.93 | $6,918.31 |
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 $1,174.90 Typical High $1,819.70 | Professional | None | $933.25 | $1,174.90 | $1,819.70 |
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 $446.68 Median $501.19 Typical High $645.65 | Professional | 52 · Reduced service | $446.68 | $501.19 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $204.17 Typical High $263.03 | Professional | 53 · Discontinued | $177.83 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $758.58 Typical High $977.24 | Professional | 54 · Surgery only | $660.69 | $758.58 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $151.36 Typical High $194.98 | Professional | 55 · Aftercare only | $131.83 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $128.82 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $707.95 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $616.60 | $707.95 | $912.01 |
Where Kentucky sits
The same service costs 18.2 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· 44th of 51
$1,047
AK $4,266TX $234
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.