How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,023 to $8,511Professionalmedian $1,096 · 10th to 90th $871 to $1,820
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 $1,122.02 Typical High $8,511.38 | Facility | None | $851.14 | $1,122.02 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,122.02 | $1,445.44 |
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 $851.14 Median $1,023.29 Typical High $1,445.44 | Professional | None | $851.14 | $1,023.29 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,548.82 Typical High $2,187.76 | Professional | 50 · Both sides | $1,258.93 | $1,548.82 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $162.18 Typical High $234.42 | Professional | 80 · Assistant surgeon | $134.90 | $162.18 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $144.54 Typical High $204.17 | Professional | AS · PA/NP assist | $117.49 | $144.54 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $4,897.79 | Facility | None | $1,047.13 | $1,698.24 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,479.11 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $3,630.78 | Facility | None | $1,819.70 | $2,290.87 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $5,495.41 | Professional | None | $1,096.48 | $1,548.82 | $5,495.41 |
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 $1,000.00 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,348.96 | $2,041.74 |
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 $549.54 Median $562.34 Typical High $645.65 | Professional | 52 · Reduced service | $549.54 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $223.87 Typical High $257.04 | Professional | 53 · Discontinued | $218.78 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $977.24 | Professional | 54 · Surgery only | $831.76 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $194.98 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $912.01 |
Where Kentucky sits
The same service costs 6.9 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· 45th of 51
$1,122
AK $4,786TX $692
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.