How much rates vary
Facilitymedian $1,549 · 10th to 90th $380 to $8,511Professionalmedian $1,862 · 10th to 90th $1,318 to $3,020
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 $1,548.82 Median $1,949.84 Typical High $2,041.74 | Facility | None | $1,548.82 | $1,949.84 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,548.82 | $1,698.24 | $2,454.71 |
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 $1,318.26 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,621.81 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,023.29 Typical High $1,737.80 | Professional | 62 · Two surgeons | $831.76 | $1,023.29 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $257.04 Typical High $446.68 | Professional | 80 · Assistant surgeon | $213.80 | $257.04 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $223.87 Typical High $389.05 | Professional | AS · PA/NP assist | $186.21 | $223.87 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,238.72 | Facility | None | $1,202.26 | $1,445.44 | $2,238.72 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,949.84 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,570.40 | Facility | None | $34.67 | $512.86 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $3,019.95 Typical High $10,232.93 | Professional | None | $1,445.44 | $3,019.95 | $10,232.93 |
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 $1,737.80 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,737.80 | $2,290.87 | $3,019.95 |
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 $776.25 Median $851.14 Typical High $1,096.48 | Professional | 52 · Reduced service | $776.25 | $851.14 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $436.52 | Professional | 53 · Discontinued | $309.03 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,258.93 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,148.15 | $1,258.93 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $257.04 Typical High $331.13 | Professional | 55 · Aftercare only | $229.09 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $169.82 Typical High $218.78 | Professional | 56 · Pre-op care only | $154.88 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,548.82 |
Where Kentucky sits
The same service costs 5.9 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
$1,862
AK $6,166TX $1,047
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.