How much rates vary
Facilitymedian $1,995 · 10th to 90th $851 to $4,365Professionalmedian $1,585 · 10th to 90th $1,202 to $2,692
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 $794.33 Median $1,621.81 Typical High $5,248.07 | Facility | None | $794.33 | $1,621.81 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,621.81 | $1,621.81 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,445.44 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $912.01 Typical High $1,445.44 | Professional | 62 · Two surgeons | $758.58 | $912.01 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $363.08 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $316.23 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $4,897.79 | Facility | None | $1,548.82 | $2,454.71 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $2,570.40 | Professional | None | $1,548.82 | $2,137.96 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $3,630.78 | Facility | None | $1,584.89 | $2,754.23 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $8,317.64 | Professional | None | $1,584.89 | $2,290.87 | $8,317.64 |
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 $1,479.11 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,479.11 | $2,041.74 | $3,019.95 |
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 $794.33 Median $812.83 Typical High $954.99 | Professional | 52 · Reduced service | $794.33 | $812.83 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | 53 · Discontinued | $323.59 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,230.27 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,202.26 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $245.47 Typical High $288.40 | Professional | 55 · Aftercare only | $239.88 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,148.15 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,148.15 | $1,318.26 |
Where Kentucky sits
The same service costs 7.1 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
$1,622
AK $7,079TX $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.