How much rates vary
Facilitymedian $2,188 · 10th to 90th $380 to $8,511Professionalmedian $2,692 · 10th to 90th $1,995 to $4,365
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 $2,290.87 Median $2,754.23 Typical High $3,090.30 | Facility | None | $2,290.87 | $2,754.23 | $3,090.30 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $3,235.94 | Professional | None | $2,290.87 | $2,511.89 | $3,235.94 |
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 $1,995.26 Median $2,398.83 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,398.83 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,513.56 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,258.93 | $1,513.56 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $380.19 Typical High $575.44 | Professional | 80 · Assistant surgeon | $316.23 | $380.19 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $338.84 Typical High $501.19 | Professional | AS · PA/NP assist | $275.42 | $338.84 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $1,778.28 Median $2,137.96 Typical High $3,311.31 | Facility | None | $1,778.28 | $2,137.96 | $3,311.31 |
CareSource Setting Professional Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $3,467.37 | Professional | None | $2,089.30 | $2,884.03 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,715.35 | Facility | None | $34.67 | $512.86 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $4,265.80 Typical High $21,379.62 | Professional | None | $2,137.96 | $4,265.80 | $21,379.62 |
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 $2,511.89 Median $3,388.44 Typical High $4,570.88 | Professional | None | $2,511.89 | $3,388.44 | $4,570.88 |
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 $1,148.15 Median $1,258.93 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,148.15 | $1,258.93 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $501.19 Typical High $645.65 | Professional | 53 · Discontinued | $457.09 | $501.19 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,905.46 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,698.24 | $1,905.46 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $380.19 Typical High $489.78 | Professional | 55 · Aftercare only | $346.74 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $251.19 Typical High $323.59 | Professional | 56 · Pre-op care only | $229.09 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,778.28 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,778.28 | $2,290.87 |
Where Kentucky sits
The same service costs 6.2 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· 34th of 51
$2,630
AK $9,120TX $1,479
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.