How much rates vary
Facilitymedian $1,349 · 10th to 90th $708 to $7,586Professionalmedian $912 · 10th to 90th $708 to $1,413
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 $707.95 Median $870.96 Typical High $1,174.90 | Facility | None | $707.95 | $870.96 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,047.13 | Professional | None | $707.95 | $812.83 | $1,047.13 |
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 $707.95 Median $912.01 Typical High $1,412.54 | Professional | None | $707.95 | $912.01 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,380.38 Typical High $2,089.30 | Professional | 50 · Both sides | $1,071.52 | $1,380.38 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $575.44 Typical High $891.25 | Professional | 62 · Two surgeons | $446.68 | $575.44 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $144.54 Typical High $223.87 | Professional | 80 · Assistant surgeon | $114.82 | $144.54 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $128.82 Typical High $194.98 | Professional | AS · PA/NP assist | $100.00 | $128.82 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,778.28 | Facility | None | $724.44 | $1,071.52 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,258.93 | Professional | None | $758.58 | $1,023.29 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,348.96 Typical High $1,949.84 | Facility | None | $34.67 | $1,348.96 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $6,165.95 | Professional | None | $794.33 | $1,096.48 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $512.86 | Professional | None | $33.11 | $33.11 | $512.86 |
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 $851.14 Median $1,047.13 Typical High $1,513.56 | Professional | None | $851.14 | $1,047.13 | $1,513.56 |
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 $354.81 Median $407.38 Typical High $524.81 | Professional | 52 · Reduced service | $354.81 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $162.18 Typical High $208.93 | Professional | 53 · Discontinued | $141.25 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $794.33 | Professional | 54 · Surgery only | $524.81 | $616.60 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $158.49 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $81.28 Typical High $104.71 | Professional | 56 · Pre-op care only | $70.79 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $741.31 |
Where Kentucky sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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 $11,256KY $2,261
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.