How much rates vary
Facilitymedian $1,318 · 10th to 90th $380 to $8,511Professionalmedian $1,549 · 10th to 90th $1,096 to $2,512
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 $1,318.26 Median $1,659.59 Typical High $1,778.28 | Facility | None | $1,318.26 | $1,659.59 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,445.44 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $6,760.83 Typical High $11,220.18 | Facility | None | $758.58 | $6,760.83 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,318.26 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $831.76 Typical High $1,479.11 | Professional | 62 · Two surgeons | $691.83 | $831.76 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $213.80 Typical High $371.54 | Professional | 80 · Assistant surgeon | $173.78 | $213.80 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $186.21 Typical High $323.59 | Professional | AS · PA/NP assist | $151.36 | $186.21 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,949.84 | Facility | None | $1,023.29 | $1,230.27 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,698.24 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,238.72 | Facility | None | $34.67 | $512.86 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $2,511.89 Typical High $8,511.38 | Professional | None | $1,230.27 | $2,511.89 | $8,511.38 |
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 $1,412.54 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,905.46 | $2,630.27 |
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 $660.69 Median $724.44 Typical High $954.99 | Professional | 52 · Reduced service | $660.69 | $724.44 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $380.19 | Professional | 53 · Discontinued | $263.03 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $281.84 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $190.55 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,318.26 |
Where Kentucky sits
The same service costs 5.0 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
$1,549
AK $5,248TX $1,047
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.