How much rates vary
Facilitymedian $2,754 · 10th to 90th $380 to $8,318Professionalmedian $3,236 · 10th to 90th $2,512 to $6,026
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 $3,090.30 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,090.30 | $3,235.94 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $3,090.30 Median $3,388.44 Typical High $4,570.88 | Professional | None | $3,090.30 | $3,388.44 | $4,570.88 |
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 $2,454.71 Median $2,951.21 Typical High $4,265.80 | Professional | None | $2,454.71 | $2,951.21 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $1,862.09 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,548.82 | $1,862.09 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $467.74 Typical High $676.08 | Professional | 80 · Assistant surgeon | $389.05 | $467.74 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $416.87 Typical High $602.56 | Professional | AS · PA/NP assist | $338.84 | $416.87 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,511.89 | $3,019.95 | $4,677.35 |
CareSource Setting Professional Modifier None Typical Low $3,235.94 Median $4,073.80 Typical High $4,897.79 | Professional | None | $3,235.94 | $4,073.80 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $5,370.32 | Facility | None | $34.67 | $691.83 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $5,754.40 Typical High $23,988.33 | Professional | None | $3,019.95 | $5,754.40 | $23,988.33 |
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 $3,235.94 Median $4,677.35 Typical High $6,456.54 | Professional | None | $3,235.94 | $4,677.35 | $6,456.54 |
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 $1,584.89 Median $1,778.28 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,584.89 | $1,778.28 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $707.95 Typical High $933.25 | Professional | 53 · Discontinued | $645.65 | $707.95 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,630.27 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,398.83 | $2,630.27 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $524.81 Typical High $691.83 | Professional | 55 · Aftercare only | $478.63 | $524.81 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $354.81 Typical High $457.09 | Professional | 56 · Pre-op care only | $316.23 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,454.71 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,454.71 | $3,235.94 |
Where Kentucky sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 43rd of 51
$3,162
AK $12,589AR $1,995
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.