How much rates vary
Facilitymedian $3,020 · 10th to 90th $724 to $15,488Professionalmedian $575 · 10th to 90th $457 to $933
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 $457.09 Median $630.96 Typical High $8,128.31 | Facility | None | $457.09 | $630.96 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $831.76 | Professional | None | $457.09 | $549.54 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $741.31 | Professional | None | $245.47 | $371.54 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $5,128.61 Typical High $20,417.38 | Facility | None | $1,174.90 | $5,128.61 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $933.25 | Professional | None | $457.09 | $575.44 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $870.96 Typical High $1,380.38 | Professional | 50 · Both sides | $691.83 | $870.96 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $91.20 Typical High $147.91 | Professional | 80 · Assistant surgeon | $74.13 | $91.20 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $81.28 Typical High $128.82 | Professional | AS · PA/NP assist | $64.57 | $81.28 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $794.33 Typical High $2,691.53 | Facility | None | $426.58 | $794.33 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $831.76 | Professional | None | $549.54 | $676.08 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,862.09 Typical High $3,890.45 | Facility | None | $891.25 | $1,862.09 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $4,073.80 | Professional | None | $512.86 | $691.83 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $389.05 | Professional | None | $33.11 | $33.11 | $389.05 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,000.00 | Professional | None | $537.03 | $660.69 | $1,000.00 |
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 $229.09 Median $263.03 Typical High $338.84 | Professional | 52 · Reduced service | $229.09 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $104.71 Typical High $134.90 | Professional | 53 · Discontinued | $93.33 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $398.11 Typical High $512.86 | Professional | 54 · Surgery only | $346.74 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $79.43 Typical High $102.33 | Professional | 55 · Aftercare only | $69.18 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $52.48 Typical High $67.61 | Professional | 56 · Pre-op care only | $45.71 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $371.54 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $323.59 | $371.54 | $478.63 |
Where Kentucky sits
The same service costs 4.7 times more in Connecticut 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
CT $8,304MT $1,762
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.