How much rates vary
Facilitymedian $1,380 · 10th to 90th $380 to $8,511Professionalmedian $1,585 · 10th to 90th $1,175 to $2,570
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 $1,380.38 Median $1,584.89 Typical High $1,819.70 | Facility | None | $1,380.38 | $1,584.89 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,513.56 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $6,760.83 Typical High $11,220.18 | Facility | None | $758.58 | $6,760.83 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,445.44 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $912.01 Typical High $1,318.26 | Professional | 62 · Two surgeons | $724.44 | $912.01 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $229.09 Typical High $338.84 | Professional | 80 · Assistant surgeon | $181.97 | $229.09 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $199.53 Typical High $295.12 | Professional | AS · PA/NP assist | $162.18 | $199.53 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,995.26 | Facility | None | $1,071.52 | $1,288.25 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,737.80 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,290.87 | Facility | None | $34.67 | $512.86 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $2,570.40 Typical High $8,317.64 | Professional | None | $1,288.25 | $2,570.40 | $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 $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 $1,479.11 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,479.11 | $1,995.26 | $2,691.53 |
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 $691.83 Median $758.58 Typical High $977.24 | Professional | 52 · Reduced service | $691.83 | $758.58 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $389.05 | Professional | 53 · Discontinued | $275.42 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $295.12 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $194.98 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,380.38 |
Where Kentucky sits
The same service costs 5.4 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· 38th of 51
$1,585
AK $5,370TX $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.