How much rates vary
Facilitymedian $1,950 · 10th to 90th $380 to $8,511Professionalmedian $2,344 · 10th to 90th $1,622 to $3,631
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 $1,949.84 Median $2,454.71 Typical High $2,630.27 | Facility | None | $1,949.84 | $2,454.71 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,949.84 | $2,137.96 | $2,818.38 |
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 $1,621.81 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,621.81 | $2,089.30 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,318.26 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,023.29 | $1,318.26 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $331.13 Typical High $537.03 | Professional | 80 · Assistant surgeon | $263.03 | $331.13 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $288.40 Typical High $467.74 | Professional | AS · PA/NP assist | $229.09 | $288.40 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,884.03 | Facility | None | $1,513.56 | $1,819.70 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $2,951.21 | Professional | None | $1,621.81 | $2,511.89 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,235.94 | Facility | None | $34.67 | $512.86 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $3,630.78 Typical High $12,882.50 | Professional | None | $1,819.70 | $3,630.78 | $12,882.50 |
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 $2,137.96 Median $2,951.21 Typical High $3,890.45 | Professional | None | $2,137.96 | $2,951.21 | $3,890.45 |
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 $977.24 Median $1,071.52 Typical High $1,412.54 | Professional | 52 · Reduced service | $977.24 | $1,071.52 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $436.52 Typical High $562.34 | Professional | 53 · Discontinued | $389.05 | $436.52 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,621.81 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,479.11 | $1,621.81 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $323.59 Typical High $416.87 | Professional | 55 · Aftercare only | $295.12 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $213.80 Typical High $281.84 | Professional | 56 · Pre-op care only | $194.98 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,513.56 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,513.56 | $1,949.84 |
Where Kentucky sits
The same service costs 6.2 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· 34th of 51
$2,344
AK $7,762TX $1,259
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.