How much rates vary
Facilitymedian $2,138 · 10th to 90th $380 to $8,511Professionalmedian $2,692 · 10th to 90th $2,042 to $5,012
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 $2,089.30 Median $2,754.23 Typical High $3,715.35 | Facility | None | $2,089.30 | $2,754.23 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,754.23 Typical High $3,981.07 | Professional | None | $2,398.83 | $2,754.23 | $3,981.07 |
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 $1,949.84 Median $2,398.83 Typical High $3,548.13 | Professional | None | $1,949.84 | $2,398.83 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,513.56 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,230.27 | $1,513.56 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $380.19 Typical High $562.34 | Professional | 80 · Assistant surgeon | $316.23 | $380.19 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $331.13 Typical High $489.78 | Professional | AS · PA/NP assist | $275.42 | $331.13 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $3,981.07 | Facility | None | $2,137.96 | $2,570.40 | $3,981.07 |
CareSource Setting Professional Modifier None Typical Low $2,511.89 Median $3,548.13 Typical High $4,168.69 | Professional | None | $2,511.89 | $3,548.13 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $4,570.88 | Facility | None | $34.67 | $512.86 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $4,897.79 Typical High $12,302.69 | Professional | None | $2,570.40 | $4,897.79 | $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 $3,890.45 Typical High $5,495.41 | Professional | None | $2,570.40 | $3,890.45 | $5,495.41 |
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 $1,348.96 Median $1,513.56 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,348.96 | $1,513.56 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $602.56 Typical High $794.33 | Professional | 53 · Discontinued | $549.54 | $602.56 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,290.87 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,041.74 | $2,290.87 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $457.09 Typical High $588.84 | Professional | 55 · Aftercare only | $407.38 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $302.00 Typical High $398.11 | Professional | 56 · Pre-op care only | $275.42 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,137.96 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,137.96 | $2,754.23 |
Where Kentucky sits
The same service costs 6.9 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 $22,987WA $3,314
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.