How much rates vary
Facilitymedian $1,660 · 10th to 90th $832 to $8,511Professionalmedian $933 · 10th to 90th $741 to $1,514
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 $933.25 Median $1,148.15 Typical High $1,174.90 | Facility | None | $933.25 | $1,148.15 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,174.90 | Professional | None | $933.25 | $1,071.52 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,332.54 Typical High $11,220.18 | Facility | None | $758.58 | $9,332.54 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,445.44 | Professional | None | $741.31 | $870.96 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,288.25 Typical High $2,187.76 | Professional | 50 · Both sides | $1,096.48 | $1,288.25 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $138.04 Typical High $234.42 | Professional | 80 · Assistant surgeon | $117.49 | $138.04 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $120.23 Typical High $204.17 | Professional | AS · PA/NP assist | $102.33 | $120.23 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $1,621.81 Typical High $2,818.38 | Facility | None | $977.24 | $1,621.81 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,380.38 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,778.28 Typical High $5,623.41 | Facility | None | $34.67 | $1,778.28 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $6,165.95 | Professional | None | $1,047.13 | $1,288.25 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $575.44 | Professional | None | $33.11 | $33.11 | $575.44 |
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 $1,202.26 Typical High $1,905.46 | Professional | None | $933.25 | $1,202.26 | $1,905.46 |
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 $467.74 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $467.74 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $186.21 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $794.33 Typical High $891.25 | Professional | 54 · Surgery only | $707.95 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $158.49 Typical High $177.83 | Professional | 55 · Aftercare only | $141.25 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $93.33 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $741.31 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $660.69 | $741.31 | $831.76 |
Where Kentucky sits
The same service costs 13.8 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· 46th of 51
$977
AK $4,467TX $324
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.