How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,023 to $8,913Professionalmedian $1,148 · 10th to 90th $912 to $1,862
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 $851.14 Median $1,148.15 Typical High $8,511.38 | Facility | None | $851.14 | $1,148.15 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,148.15 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,513.56 | Professional | None | $912.01 | $1,122.02 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,659.59 Typical High $2,238.72 | Professional | 50 · Both sides | $1,380.38 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $691.83 Typical High $954.99 | Professional | 62 · Two surgeons | $575.44 | $691.83 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $177.83 Typical High $239.88 | Professional | 80 · Assistant surgeon | $147.91 | $177.83 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $208.93 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $6,309.57 | Facility | None | $1,071.52 | $1,737.80 | $6,309.57 |
CareSource Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,513.56 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $4,570.88 | Facility | None | $1,862.09 | $2,290.87 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $5,754.40 | Professional | None | $1,122.02 | $1,584.89 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,412.54 | $2,089.30 |
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 $562.34 Median $575.44 Typical High $660.69 | Professional | 52 · Reduced service | $562.34 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | 53 · Discontinued | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $870.96 Typical High $1,000.00 | Professional | 54 · Surgery only | $851.14 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $173.78 Typical High $199.53 | Professional | 55 · Aftercare only | $169.82 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $812.83 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $812.83 | $933.25 |
Where Kentucky sits
The same service costs 6.6 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
$1,175
AK $4,898TX $741
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.