How much rates vary
Facilitymedian $2,138 · 10th to 90th $389 to $8,318Professionalmedian $2,570 · 10th to 90th $1,862 to $4,074
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 $2,137.96 Median $2,630.27 Typical High $2,818.38 | Facility | None | $2,137.96 | $2,630.27 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $3,019.95 | Professional | None | $2,137.96 | $2,344.23 | $3,019.95 |
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 $1,862.09 Median $2,238.72 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,238.72 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,412.54 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,174.90 | $1,412.54 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $363.08 Typical High $549.54 | Professional | 80 · Assistant surgeon | $295.12 | $363.08 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $316.23 Typical High $478.63 | Professional | AS · PA/NP assist | $263.03 | $316.23 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $3,090.30 | Facility | None | $1,659.59 | $1,995.26 | $3,090.30 |
CareSource Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $3,162.28 | Professional | None | $1,905.46 | $2,691.53 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $3,467.37 | Facility | None | $34.67 | $691.83 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $3,981.07 Typical High $13,803.84 | Professional | None | $1,995.26 | $3,981.07 | $13,803.84 |
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 $2,344.23 Median $3,162.28 Typical High $4,265.80 | Professional | None | $2,344.23 | $3,162.28 | $4,265.80 |
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 $1,071.52 Median $1,174.90 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,071.52 | $1,174.90 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $467.74 Typical High $602.56 | Professional | 53 · Discontinued | $426.58 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,737.80 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,584.89 | $1,737.80 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $354.81 Typical High $457.09 | Professional | 55 · Aftercare only | $316.23 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $234.42 Typical High $302.00 | Professional | 56 · Pre-op care only | $213.80 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,621.81 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,621.81 | $2,137.96 |
Where Kentucky sits
The same service costs 5.4 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· 38th of 51
$2,455
AK $8,318TX $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.