How much rates vary
Facilitymedian $2,455 · 10th to 90th $741 to $9,772Professionalmedian $741 · 10th to 90th $479 to $1,202
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 $512.86 Median $851.14 Typical High $1,819.70 | Facility | None | $512.86 | $851.14 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,096.48 | Professional | None | $512.86 | $758.58 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $831.76 | Professional | None | $251.19 | $251.19 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $1,047.13 | Professional | None | $457.09 | $537.03 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $812.83 Typical High $1,584.89 | Professional | 50 · Both sides | $691.83 | $812.83 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $338.84 Typical High $660.69 | Professional | 62 · Two surgeons | $288.40 | $338.84 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $87.10 Typical High $169.82 | Professional | 80 · Assistant surgeon | $74.13 | $87.10 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $75.86 Typical High $147.91 | Professional | AS · PA/NP assist | $64.57 | $75.86 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $7,585.78 | Facility | None | $549.54 | $891.25 | $7,585.78 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $912.01 | Professional | None | $537.03 | $741.31 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $2,511.89 Typical High $5,623.41 | Facility | None | $977.24 | $2,511.89 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $933.25 Typical High $5,248.07 | Professional | None | $562.34 | $933.25 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $426.58 | Professional | None | $33.11 | $33.11 | $426.58 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $7,079.46 | Facility | None | $741.31 | $1,479.11 | $7,079.46 |
United Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,380.38 | Professional | None | $691.83 | $912.01 | $1,380.38 |
12 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 Facility Modifier 52 · Reduced service Typical Low $257.04 Median $407.38 Typical High $512.86 | Facility | 52 · Reduced service | $257.04 | $407.38 | $512.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $102.33 Median $165.96 Typical High $204.17 | Facility | 53 · Discontinued | $102.33 | $165.96 | $204.17 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $380.19 Median $616.60 Typical High $758.58 | Facility | 54 · Surgery only | $380.19 | $616.60 | $758.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $75.86 Median $123.03 Typical High $151.36 | Facility | 55 · Aftercare only | $75.86 | $123.03 | $151.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $51.29 Median $81.28 Typical High $102.33 | Facility | 56 · Pre-op care only | $51.29 | $81.28 | $102.33 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $575.44 Typical High $707.95 | Facility | 78 · Unplanned return to OR | $354.81 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $398.11 Typical High $512.86 | Professional | 52 · Reduced service | $257.04 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $162.18 Typical High $204.17 | Professional | 53 · Discontinued | $102.33 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $602.56 Typical High $758.58 | Professional | 54 · Surgery only | $380.19 | $602.56 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $120.23 Typical High $151.36 | Professional | 55 · Aftercare only | $75.86 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $79.43 Typical High $102.33 | Professional | 56 · Pre-op care only | $51.29 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $562.34 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $354.81 | $562.34 | $707.95 |
Where Kentucky sits
The same service costs 5.1 times more in Alaska than in West Virginia. 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
AK $10,217WV $2,002
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.