How much rates vary
Facilitymedian $1,698 · 10th to 90th $457 to $11,220Professionalmedian $1,047 · 10th to 90th $813 to $1,660
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 $954.99 Median $954.99 Typical High $1,096.48 | Facility | None | $954.99 | $954.99 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | None | $954.99 | $954.99 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $10,000.00 Typical High $16,218.10 | Facility | None | $5,754.40 | $10,000.00 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,513.56 | Professional | None | $812.83 | $1,023.29 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $645.65 Typical High $954.99 | Professional | 62 · Two surgeons | $512.86 | $645.65 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $162.18 Typical High $239.88 | Professional | 80 · Assistant surgeon | $131.83 | $162.18 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $141.25 Typical High $208.93 | Professional | AS · PA/NP assist | $114.82 | $141.25 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $1,445.44 | Facility | None | $776.25 | $933.25 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,513.56 | Professional | None | $912.01 | $1,258.93 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,698.24 | Facility | None | $34.67 | $512.86 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $5,754.40 | Professional | None | $933.25 | $1,412.54 | $5,754.40 |
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 $870.96 Median $1,258.93 Typical High $1,778.28 | Professional | None | $870.96 | $1,258.93 | $1,778.28 |
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 $478.63 Median $478.63 Typical High $549.54 | Professional | 52 · Reduced service | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $218.78 | Professional | 53 · Discontinued | $190.55 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | 54 · Surgery only | $724.44 | $724.44 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $776.25 |
Where Kentucky sits
The same service costs 6.8 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· 40th of 51
$1,072
AK $3,981TX $589
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.