How much rates vary
Facilitymedian $2,089 · 10th to 90th $389 to $8,318Professionalmedian $2,512 · 10th to 90th $1,738 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 $2,089.30 Median $2,570.40 Typical High $2,754.23 | Facility | None | $2,089.30 | $2,570.40 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,238.72 | $2,951.21 |
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 $1,737.80 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,737.80 | $2,238.72 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,412.54 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,096.48 | $1,412.54 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $363.08 Typical High $575.44 | Professional | 80 · Assistant surgeon | $275.42 | $363.08 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $316.23 Typical High $501.19 | Professional | AS · PA/NP assist | $239.88 | $316.23 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $3,019.95 | Facility | None | $1,584.89 | $1,905.46 | $3,019.95 |
CareSource Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,089.30 | $2,630.27 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $3,388.44 | Facility | None | $34.67 | $691.83 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $3,801.89 Typical High $19,952.62 | Professional | None | $1,949.84 | $3,801.89 | $19,952.62 |
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 $4,168.69 | Professional | None | $2,238.72 | $3,162.28 | $4,168.69 |
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 $1,023.29 Median $1,148.15 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,023.29 | $1,148.15 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $457.09 Typical High $588.84 | Professional | 53 · Discontinued | $416.87 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,698.24 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,548.82 | $1,698.24 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $338.84 Typical High $436.52 | Professional | 55 · Aftercare only | $309.03 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $229.09 Typical High $295.12 | Professional | 56 · Pre-op care only | $208.93 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,584.89 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,584.89 | $2,041.74 |
Where Kentucky sits
The same service costs 5.2 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· 35th of 51
$2,455
AK $8,128TX $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.