How much rates vary
Facilitymedian $2,754 · 10th to 90th $380 to $8,511Professionalmedian $3,388 · 10th to 90th $2,692 to $5,754
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 $3,019.95 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,019.95 | $3,235.94 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $4,570.88 | Professional | None | $3,019.95 | $3,548.13 | $4,570.88 |
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 $2,691.53 Median $3,162.28 Typical High $4,073.80 | Professional | None | $2,691.53 | $3,162.28 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $501.19 Typical High $630.96 | Professional | 80 · Assistant surgeon | $426.58 | $501.19 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $446.68 Typical High $562.34 | Professional | AS · PA/NP assist | $371.54 | $446.68 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,511.89 | $3,019.95 | $4,677.35 |
CareSource Setting Professional Modifier None Typical Low $3,235.94 Median $4,168.69 Typical High $4,897.79 | Professional | None | $3,235.94 | $4,168.69 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $5,248.07 | Facility | None | $34.67 | $512.86 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $5,754.40 Typical High $16,595.87 | Professional | None | $3,019.95 | $5,754.40 | $16,595.87 |
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 $3,630.78 Median $5,128.61 Typical High $6,456.54 | Professional | None | $3,630.78 | $5,128.61 | $6,456.54 |
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 $1,513.56 Median $1,778.28 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,513.56 | $1,778.28 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $707.95 Typical High $933.25 | Professional | 53 · Discontinued | $602.56 | $707.95 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,630.27 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,238.72 | $2,630.27 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $524.81 Typical High $691.83 | Professional | 55 · Aftercare only | $457.09 | $524.81 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $354.81 Typical High $457.09 | Professional | 56 · Pre-op care only | $302.00 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,454.71 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,454.71 | $3,235.94 |
Where Kentucky sits
The same service costs 7.1 times more in Alaska than in Arkansas. 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· 44th of 51
$3,236
AK $12,882AR $1,820
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.