How much rates vary
Facilitymedian $912 · 10th to 90th $389 to $8,318Professionalmedian $933 · 10th to 90th $676 to $1,445
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 $1,023.29 Typical High $1,047.13 | Facility | None | $794.33 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,258.93 | Professional | None | $794.33 | $851.14 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,258.93 | Professional | None | $645.65 | $831.76 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $524.81 Typical High $794.33 | Professional | 62 · Two surgeons | $407.38 | $524.81 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $131.83 Typical High $204.17 | Professional | 80 · Assistant surgeon | $104.71 | $131.83 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $114.82 Typical High $177.83 | Professional | AS · PA/NP assist | $91.20 | $114.82 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $724.44 Typical High $1,148.15 | Facility | None | $616.60 | $724.44 | $1,148.15 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,174.90 | Professional | None | $724.44 | $1,000.00 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,348.96 | Facility | None | $34.67 | $691.83 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,445.44 Typical High $5,370.32 | Professional | None | $741.31 | $1,445.44 | $5,370.32 |
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 $1,122.02 Typical High $1,548.82 | Professional | None | $870.96 | $1,122.02 | $1,548.82 |
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 $398.11 Median $426.58 Typical High $562.34 | Professional | 52 · Reduced service | $398.11 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $229.09 | Professional | 53 · Discontinued | $158.49 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $851.14 | Professional | 54 · Surgery only | $588.84 | $645.65 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $169.82 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $114.82 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $794.33 |
Where Kentucky sits
The same service costs 4.6 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· 40th of 51
$933
AK $3,162TX $692
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.