How much rates vary
Facilitymedian $2,399 · 10th to 90th $389 to $8,318Professionalmedian $2,818 · 10th to 90th $2,042 to $4,571
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 $2,398.83 Median $2,951.21 Typical High $3,162.28 | Facility | None | $2,398.83 | $2,951.21 | $3,162.28 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,630.27 | $3,388.44 |
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 $2,041.74 Median $2,511.89 Typical High $3,715.35 | Professional | None | $2,041.74 | $2,511.89 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,584.89 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,288.25 | $1,584.89 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $398.11 Typical High $588.84 | Professional | 80 · Assistant surgeon | $331.13 | $398.11 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $346.74 Typical High $524.81 | Professional | AS · PA/NP assist | $288.40 | $346.74 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $3,467.37 | Facility | None | $1,819.70 | $2,187.76 | $3,467.37 |
CareSource Setting Professional Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $3,548.13 | Professional | None | $1,949.84 | $3,019.95 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $3,890.45 | Facility | None | $34.67 | $691.83 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $4,466.84 Typical High $22,908.68 | Professional | None | $2,238.72 | $4,466.84 | $22,908.68 |
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 $2,630.27 Median $3,548.13 Typical High $4,677.35 | Professional | None | $2,630.27 | $3,548.13 | $4,677.35 |
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 $1,202.26 Median $1,318.26 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,202.26 | $1,318.26 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $524.81 Typical High $676.08 | Professional | 53 · Discontinued | $478.63 | $524.81 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,949.84 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,778.28 | $1,949.84 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $389.05 Typical High $512.86 | Professional | 55 · Aftercare only | $354.81 | $389.05 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $263.03 Typical High $338.84 | Professional | 56 · Pre-op care only | $239.88 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,819.70 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,819.70 | $2,344.23 |
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
$2,754
AK $9,333TX $1,622
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.