How much rates vary
Facilitymedian $2,188 · 10th to 90th $389 to $8,318Professionalmedian $2,570 · 10th to 90th $2,089 to $4,677
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 $1,905.46 Median $2,951.21 Typical High $2,951.21 | Facility | None | $1,905.46 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,951.21 Typical High $3,311.31 | Professional | None | $2,884.03 | $2,951.21 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $11,220.18 | Facility | None | $758.58 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,630.78 | Professional | None | $2,089.30 | $2,454.71 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,548.82 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,318.26 | $1,548.82 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $398.11 Typical High $562.34 | Professional | 80 · Assistant surgeon | $331.13 | $398.11 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $346.74 Typical High $489.78 | Professional | AS · PA/NP assist | $295.12 | $346.74 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $4,466.84 | Facility | None | $2,398.83 | $2,818.38 | $4,466.84 |
CareSource Setting Professional Modifier None Typical Low $2,818.38 Median $3,890.45 Typical High $4,570.88 | Professional | None | $2,818.38 | $3,890.45 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $5,011.87 | Facility | None | $34.67 | $691.83 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $4,073.80 Typical High $13,489.63 | Professional | None | $2,884.03 | $4,073.80 | $13,489.63 |
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 $2,511.89 Median $3,548.13 Typical High $5,623.41 | Professional | None | $2,511.89 | $3,548.13 | $5,623.41 |
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 $1,445.44 Median $1,479.11 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,445.44 | $1,479.11 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $588.84 Typical High $660.69 | Professional | 53 · Discontinued | $575.44 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,238.72 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,187.76 | $2,238.72 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $446.68 Typical High $489.78 | Professional | 55 · Aftercare only | $436.52 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $295.12 Typical High $331.13 | Professional | 56 · Pre-op care only | $288.40 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,089.30 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,089.30 | $2,290.87 |
Where Kentucky sits
The same service costs 12.6 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· 45th of 51
$2,570
AK $12,023TX $955
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.