How much rates vary
Facilitymedian $2,188 · 10th to 90th $457 to $14,454Professionalmedian $1,862 · 10th to 90th $1,380 to $3,020
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 $1,621.81 Median $1,819.70 Typical High $2,187.76 | Facility | None | $1,621.81 | $1,819.70 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,819.70 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $11,220.18 Typical High $20,892.96 | Facility | None | $6,165.95 | $11,220.18 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,698.24 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,071.52 Typical High $1,513.56 | Professional | 62 · Two surgeons | $851.14 | $1,071.52 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $275.42 Typical High $380.19 | Professional | 80 · Assistant surgeon | $218.78 | $275.42 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $239.88 Typical High $338.84 | Professional | AS · PA/NP assist | $190.55 | $239.88 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,398.83 | Facility | None | $1,258.93 | $1,513.56 | $2,398.83 |
CareSource Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,479.11 | $2,089.30 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,691.53 | Facility | None | $34.67 | $512.86 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,951.21 Typical High $9,332.54 | Professional | None | $1,513.56 | $2,951.21 | $9,332.54 |
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 $1,778.28 Median $2,398.83 Typical High $3,235.94 | Professional | None | $1,778.28 | $2,398.83 | $3,235.94 |
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 $812.83 Median $891.25 Typical High $1,174.90 | Professional | 52 · Reduced service | $812.83 | $891.25 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $363.08 Typical High $467.74 | Professional | 53 · Discontinued | $331.13 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,348.96 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,230.27 | $1,348.96 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $269.15 Typical High $346.74 | Professional | 55 · Aftercare only | $245.47 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $181.97 Typical High $234.42 | Professional | 56 · Pre-op care only | $162.18 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,258.93 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,258.93 | $1,621.81 |
Where Kentucky sits
The same service costs 5.5 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· 37th of 51
$1,950
AK $6,457TX $1,175
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.