How much rates vary
Facilitymedian $2,951 · 10th to 90th $794 to $10,000Professionalmedian $575 · 10th to 90th $417 to $1,000
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 $524.81 Median $645.65 Typical High $3,235.94 | Facility | None | $524.81 | $645.65 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $645.65 | Professional | None | $524.81 | $588.84 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,071.52 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $1,000.00 | Professional | None | $416.87 | $501.19 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $758.58 Typical High $1,479.11 | Professional | 50 · Both sides | $630.96 | $758.58 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $316.23 Typical High $630.96 | Professional | 62 · Two surgeons | $263.03 | $316.23 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $81.28 Typical High $158.49 | Professional | 80 · Assistant surgeon | $66.07 | $81.28 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $70.79 Typical High $138.04 | Professional | AS · PA/NP assist | $58.88 | $70.79 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $912.01 Typical High $14,454.40 | Facility | None | $489.78 | $912.01 | $14,454.40 |
CareSource Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $933.25 | Professional | None | $575.44 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,290.87 Typical High $11,481.54 | Facility | None | $1,000.00 | $2,290.87 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $4,466.84 | Professional | None | $588.84 | $794.33 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $398.11 | Professional | None | $33.11 | $33.11 | $398.11 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $8,912.51 | Facility | None | $977.24 | $1,862.09 | $8,912.51 |
United Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,096.48 | Professional | None | $602.56 | $724.44 | $1,096.48 |
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 $263.03 Median $302.00 Typical High $389.05 | Professional | 52 · Reduced service | $263.03 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $120.23 Typical High $154.88 | Professional | 53 · Discontinued | $104.71 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $575.44 | Professional | 54 · Surgery only | $398.11 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $117.49 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $60.26 Typical High $77.62 | Professional | 56 · Pre-op care only | $52.48 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $537.03 |
Where Kentucky sits
The same service costs 10.1 times more in Alaska 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
AK $19,890MT $1,977
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.