How much rates vary
Facilitymedian $1,479 · 10th to 90th $389 to $8,318Professionalmedian $1,622 · 10th to 90th $1,230 to $2,630
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 $1,445.44 Median $1,584.89 Typical High $1,905.46 | Facility | None | $1,445.44 | $1,584.89 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,445.44 | $1,548.82 | $2,238.72 |
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 $1,202.26 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,479.11 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $933.25 Typical High $1,318.26 | Professional | 62 · Two surgeons | $758.58 | $933.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $234.42 Typical High $338.84 | Professional | 80 · Assistant surgeon | $190.55 | $234.42 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $208.93 Typical High $295.12 | Professional | AS · PA/NP assist | $165.96 | $208.93 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,089.30 | Facility | None | $1,096.48 | $1,318.26 | $2,089.30 |
CareSource Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,819.70 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,398.83 | Facility | None | $34.67 | $691.83 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $8,317.64 | Professional | None | $1,318.26 | $2,630.27 | $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 $1,548.82 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,548.82 | $2,041.74 | $2,818.38 |
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 $707.95 Median $776.25 Typical High $1,023.29 | Professional | 52 · Reduced service | $707.95 | $776.25 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $316.23 Typical High $407.38 | Professional | 53 · Discontinued | $288.40 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,174.90 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,071.52 | $1,174.90 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $234.42 Typical High $309.03 | Professional | 55 · Aftercare only | $213.80 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $154.88 Typical High $204.17 | Professional | 56 · Pre-op care only | $144.54 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,096.48 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,096.48 | $1,445.44 |
Where Kentucky sits
The same service costs 5.6 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· 38th of 51
$1,585
AK $5,623TX $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.