How much rates vary
Facilitymedian $2,512 · 10th to 90th $389 to $8,318Professionalmedian $3,090 · 10th to 90th $2,291 to $5,129
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 $2,511.89 Median $2,691.53 Typical High $3,630.78 | Facility | None | $2,511.89 | $2,691.53 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $3,890.45 | Professional | None | $2,691.53 | $2,951.21 | $3,890.45 |
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 $2,290.87 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,290.87 | $2,884.03 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $457.09 Typical High $602.56 | Professional | 80 · Assistant surgeon | $363.08 | $457.09 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $398.11 Typical High $524.81 | Professional | AS · PA/NP assist | $323.59 | $398.11 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,511.89 | $3,981.07 |
CareSource Setting Professional Modifier None Typical Low $2,454.71 Median $3,467.37 Typical High $4,073.80 | Professional | None | $2,454.71 | $3,467.37 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $4,466.84 | Facility | None | $34.67 | $691.83 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $4,897.79 Typical High $13,182.57 | Professional | None | $2,511.89 | $4,897.79 | $13,182.57 |
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 $2,818.38 Median $3,890.45 Typical High $5,370.32 | Professional | None | $2,818.38 | $3,890.45 | $5,370.32 |
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 $1,479.11 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,348.96 | $1,479.11 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $588.84 Typical High $776.25 | Professional | 53 · Discontinued | $537.03 | $588.84 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,238.72 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,995.26 | $2,238.72 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $446.68 Typical High $575.44 | Professional | 55 · Aftercare only | $398.11 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $295.12 Typical High $389.05 | Professional | 56 · Pre-op care only | $269.15 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,089.30 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,089.30 | $2,691.53 |
Where Kentucky sits
The same service costs 6.9 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· 37th of 51
$2,951
AK $10,715TX $1,549
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.