How much rates vary
Facilitymedian $1,995 · 10th to 90th $380 to $8,511Professionalmedian $2,455 · 10th to 90th $1,698 to $3,890
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 $1,995.26 Median $2,630.27 Typical High $2,691.53 | Facility | None | $1,995.26 | $2,630.27 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,884.03 | Professional | None | $1,995.26 | $2,238.72 | $2,884.03 |
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 $1,698.24 Median $2,187.76 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,187.76 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,380.38 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,071.52 | $1,380.38 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $346.74 Typical High $575.44 | Professional | 80 · Assistant surgeon | $269.15 | $346.74 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $309.03 Typical High $501.19 | Professional | AS · PA/NP assist | $234.42 | $309.03 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,951.21 | Facility | None | $1,548.82 | $1,862.09 | $2,951.21 |
CareSource Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $3,019.95 | Professional | None | $1,995.26 | $2,570.40 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,311.31 | Facility | None | $34.67 | $512.86 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $3,715.35 Typical High $13,489.63 | Professional | None | $1,862.09 | $3,715.35 | $13,489.63 |
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 $2,238.72 Median $3,162.28 Typical High $3,981.07 | Professional | None | $2,238.72 | $3,162.28 | $3,981.07 |
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 $1,000.00 Median $1,096.48 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,000.00 | $1,096.48 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $446.68 Typical High $575.44 | Professional | 53 · Discontinued | $407.38 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,659.59 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,513.56 | $1,659.59 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $331.13 Typical High $426.58 | Professional | 55 · Aftercare only | $302.00 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $223.87 Typical High $288.40 | Professional | 56 · Pre-op care only | $199.53 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,548.82 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,548.82 | $1,995.26 |
Where Kentucky sits
The same service costs 5.8 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· 36th of 51
$2,399
AK $7,943TX $1,380
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.