How much rates vary
Facilitymedian $1,862 · 10th to 90th $380 to $8,511Professionalmedian $2,239 · 10th to 90th $1,622 to $3,548
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 $1,862.09 Median $2,344.23 Typical High $2,511.89 | Facility | None | $1,862.09 | $2,344.23 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,862.09 | $2,041.74 | $2,818.38 |
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 $1,621.81 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,621.81 | $1,949.84 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $309.03 Typical High $489.78 | Professional | 80 · Assistant surgeon | $257.04 | $309.03 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $275.42 Typical High $436.52 | Professional | AS · PA/NP assist | $223.87 | $275.42 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,691.53 | Facility | None | $1,445.44 | $1,737.80 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,862.09 | $2,398.83 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,090.30 | Facility | None | $34.67 | $512.86 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $18,197.01 | Professional | None | $1,737.80 | $3,548.13 | $18,197.01 |
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 $2,818.38 Typical High $3,715.35 | Professional | None | $2,137.96 | $2,818.38 | $3,715.35 |
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 $933.25 Median $1,023.29 Typical High $1,318.26 | Professional | 52 · Reduced service | $933.25 | $1,023.29 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $407.38 Typical High $537.03 | Professional | 53 · Discontinued | $371.54 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,548.82 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,412.54 | $1,548.82 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $309.03 Typical High $398.11 | Professional | 55 · Aftercare only | $281.84 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $204.17 Typical High $269.15 | Professional | 56 · Pre-op care only | $186.21 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,445.44 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,445.44 | $1,862.09 |
Where Kentucky sits
The same service costs 6.3 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
$2,188
AK $7,413TX $1,175
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.