How much rates vary
Facilitymedian $1,479 · 10th to 90th $759 to $7,943Professionalmedian $1,514 · 10th to 90th $1,175 to $2,399
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 $1,348.96 Typical High $8,511.38 | Facility | None | $851.14 | $1,348.96 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,348.96 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,513.56 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $954.99 Typical High $1,288.25 | Professional | 62 · Two surgeons | $707.95 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $239.88 Typical High $323.59 | Professional | 80 · Assistant surgeon | $177.83 | $239.88 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $213.80 Typical High $281.84 | Professional | AS · PA/NP assist | $158.49 | $213.80 | $281.84 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,041.74 | Facility | None | $1,000.00 | $1,445.44 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,778.28 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,187.76 Typical High $3,630.78 | Facility | None | $34.67 | $2,187.76 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $9,120.11 | Professional | None | $1,318.26 | $2,041.74 | $9,120.11 |
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 $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 $1,318.26 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,862.09 | $2,570.40 |
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 $676.08 Median $676.08 Typical High $870.96 | Professional | 52 · Reduced service | $676.08 | $676.08 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $346.74 | Professional | 53 · Discontinued | $269.15 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $257.04 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,202.26 |
Where Kentucky sits
The same service costs 6.5 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· 43rd of 51
$1,514
AK $5,754TX $891
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.