How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $11,220Professionalmedian $1,862 · 10th to 90th $1,479 to $3,090
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 $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,862.09 | $1,862.09 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $10,000.00 Typical High $16,218.10 | Facility | None | $6,025.60 | $10,000.00 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,737.80 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,096.48 Typical High $1,621.81 | Professional | 62 · Two surgeons | $891.25 | $1,096.48 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $275.42 Typical High $416.87 | Professional | 80 · Assistant surgeon | $229.09 | $275.42 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $239.88 Typical High $363.08 | Professional | AS · PA/NP assist | $199.53 | $239.88 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,818.38 | Facility | None | $1,479.11 | $1,778.28 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,454.71 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,019.95 | Facility | None | $34.67 | $512.86 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $9,772.37 | Professional | None | $1,819.70 | $2,691.53 | $9,772.37 |
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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,290.87 | $3,467.37 |
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 $912.01 Median $933.25 Typical High $1,071.52 | Professional | 52 · Reduced service | $912.01 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | 53 · Discontinued | $371.54 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,412.54 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,380.38 | $1,412.54 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $281.84 Typical High $323.59 | Professional | 55 · Aftercare only | $275.42 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,318.26 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,318.26 | $1,479.11 |
Where Kentucky sits
The same service costs 7.8 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· 44th of 51
$1,862
AK $7,762TX $1,000
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.