How much rates vary
Facilitymedian $1,549 · 10th to 90th $380 to $8,511Professionalmedian $1,778 · 10th to 90th $1,259 to $2,884
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 $1,479.11 Median $1,905.46 Typical High $1,995.26 | Facility | None | $1,479.11 | $1,905.46 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,479.11 | $1,621.81 | $2,344.23 |
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 $1,230.27 Median $1,548.82 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,548.82 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $977.24 Typical High $1,778.28 | Professional | 62 · Two surgeons | $776.25 | $977.24 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $251.19 Typical High $446.68 | Professional | 80 · Assistant surgeon | $194.98 | $251.19 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $218.78 Typical High $389.05 | Professional | AS · PA/NP assist | $169.82 | $218.78 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,137.96 | Facility | None | $1,148.15 | $1,380.38 | $2,137.96 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,905.46 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,454.71 | Facility | None | $34.67 | $512.86 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $2,691.53 Typical High $10,000.00 | Professional | None | $1,380.38 | $2,691.53 | $10,000.00 |
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 $1,621.81 Median $2,290.87 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,290.87 | $2,884.03 |
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 $741.31 Median $812.83 Typical High $1,047.13 | Professional | 52 · Reduced service | $741.31 | $812.83 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $323.59 Typical High $426.58 | Professional | 53 · Discontinued | $295.12 | $323.59 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,202.26 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,122.02 | $1,202.26 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $245.47 Typical High $316.23 | Professional | 55 · Aftercare only | $223.87 | $245.47 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $162.18 Typical High $208.93 | Professional | 56 · Pre-op care only | $147.91 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,122.02 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,122.02 | $1,479.11 |
Where Kentucky sits
The same service costs 5.9 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· 35th of 51
$1,778
AK $5,888TX $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.