How much rates vary
Facilitymedian $2,089 · 10th to 90th $380 to $8,511Professionalmedian $2,042 · 10th to 90th $1,585 to $4,365
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 $2,454.71 Typical High $3,311.31 | Facility | None | $1,380.38 | $2,454.71 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $3,467.37 | Professional | None | $2,398.83 | $2,691.53 | $3,467.37 |
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 $1,584.89 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,949.84 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,230.27 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,000.00 | $1,230.27 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $309.03 Typical High $426.58 | Professional | 80 · Assistant surgeon | $251.19 | $309.03 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $275.42 Typical High $371.54 | Professional | AS · PA/NP assist | $218.78 | $275.42 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $3,548.13 | Facility | None | $1,905.46 | $2,290.87 | $3,548.13 |
CareSource Setting Professional Modifier None Typical Low $2,238.72 Median $3,162.28 Typical High $3,715.35 | Professional | None | $2,238.72 | $3,162.28 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $4,073.80 | Facility | None | $34.67 | $512.86 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $4,365.16 Typical High $10,964.78 | Professional | None | $2,290.87 | $4,365.16 | $10,964.78 |
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 $1,995.26 Median $3,467.37 Typical High $4,897.79 | Professional | None | $1,995.26 | $3,467.37 | $4,897.79 |
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 $1,202.26 Median $1,348.96 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,202.26 | $1,348.96 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $537.03 Typical High $691.83 | Professional | 53 · Discontinued | $489.78 | $537.03 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,995.26 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,819.70 | $1,995.26 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $398.11 Typical High $524.81 | Professional | 55 · Aftercare only | $363.08 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $269.15 Typical High $346.74 | Professional | 56 · Pre-op care only | $239.88 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,862.09 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,862.09 | $2,454.71 |
Where Kentucky sits
The same service costs 7.1 times more in Alaska than in Washington. 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.
Physician feeFacility fee
AK $21,795WA $3,089
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.