How much rates vary
Facilitymedian $2,344 · 10th to 90th $380 to $8,511Professionalmedian $2,630 · 10th to 90th $2,042 to $4,786
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 $2,344.23 Median $2,570.40 Typical High $3,388.44 | Facility | None | $2,344.23 | $2,570.40 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $3,630.78 | Professional | None | $2,511.89 | $2,818.38 | $3,630.78 |
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 $2,041.74 Median $2,511.89 Typical High $3,388.44 | Professional | None | $2,041.74 | $2,511.89 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,548.82 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,288.25 | $1,548.82 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $398.11 Typical High $537.03 | Professional | 80 · Assistant surgeon | $331.13 | $398.11 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $346.74 Typical High $467.74 | Professional | AS · PA/NP assist | $288.40 | $346.74 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $3,715.35 | Facility | None | $1,995.26 | $2,398.83 | $3,715.35 |
CareSource Setting Professional Modifier None Typical Low $2,137.96 Median $3,235.94 Typical High $3,801.89 | Professional | None | $2,137.96 | $3,235.94 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $4,265.80 | Facility | None | $34.67 | $512.86 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $4,570.88 Typical High $12,302.69 | Professional | None | $2,398.83 | $4,570.88 | $12,302.69 |
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 $2,570.40 Median $3,630.78 Typical High $5,011.87 | Professional | None | $2,570.40 | $3,630.78 | $5,011.87 |
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 $1,258.93 Median $1,380.38 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,258.93 | $1,380.38 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $562.34 Typical High $724.44 | Professional | 53 · Discontinued | $501.19 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,089.30 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,905.46 | $2,089.30 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $416.87 Typical High $549.54 | Professional | 55 · Aftercare only | $380.19 | $416.87 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $281.84 Typical High $363.08 | Professional | 56 · Pre-op care only | $251.19 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,949.84 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,949.84 | $2,570.40 |
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 $22,023WA $3,113
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.