How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,023 to $10,233Professionalmedian $1,230 · 10th to 90th $977 to $1,995
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 $891.25 Median $1,230.27 Typical High $8,511.38 | Facility | None | $891.25 | $1,230.27 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,230.27 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,659.59 | Professional | None | $977.24 | $1,174.90 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $741.31 Typical High $1,047.13 | Professional | 62 · Two surgeons | $616.60 | $741.31 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $190.55 Typical High $257.04 | Professional | 80 · Assistant surgeon | $154.88 | $190.55 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $229.09 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $4,897.79 | Facility | None | $977.24 | $1,862.09 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,621.81 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,630.78 | Facility | None | $1,995.26 | $2,511.89 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $6,760.83 | Professional | None | $1,202.26 | $1,659.59 | $6,760.83 |
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 $1,096.48 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,479.11 | $2,238.72 |
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 $602.56 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $239.88 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,000.00 |
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· 44th of 51
$1,288
AK $5,248TX $794
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.