How much rates vary
Facilitymedian $2,239 · 10th to 90th $380 to $8,511Professionalmedian $2,692 · 10th to 90th $1,995 to $4,467
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 $2,398.83 Typical High $3,235.94 | Facility | None | $2,344.23 | $2,398.83 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $3,801.89 | Professional | None | $2,238.72 | $2,511.89 | $3,801.89 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $1,995.26 Median $2,511.89 Typical High $3,162.28 | Professional | None | $1,995.26 | $2,511.89 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,584.89 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,258.93 | $1,584.89 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $407.38 Typical High $512.86 | Professional | 80 · Assistant surgeon | $316.23 | $407.38 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $354.81 Typical High $446.68 | Professional | AS · PA/NP assist | $281.84 | $354.81 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $3,467.37 | Facility | None | $1,862.09 | $2,238.72 | $3,467.37 |
CareSource Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,630.78 | Professional | None | $2,398.83 | $3,019.95 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,981.07 | Facility | None | $34.67 | $512.86 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $4,265.80 Typical High $12,302.69 | Professional | None | $2,238.72 | $4,265.80 | $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 $2,454.71 Median $3,388.44 Typical High $4,786.30 | Professional | None | $2,454.71 | $3,388.44 | $4,786.30 |
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 $1,174.90 Median $1,318.26 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,174.90 | $1,318.26 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $524.81 Typical High $676.08 | Professional | 53 · Discontinued | $467.74 | $524.81 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,949.84 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,778.28 | $1,949.84 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $389.05 Typical High $512.86 | Professional | 55 · Aftercare only | $354.81 | $389.05 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $263.03 Typical High $338.84 | Professional | 56 · Pre-op care only | $234.42 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,819.70 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,819.70 | $2,398.83 |
Where Kentucky sits
The same service costs 7.2 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 $21,573WA $2,995
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.