How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $8,913Professionalmedian $1,349 · 10th to 90th $1,148 to $2,692
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 $1,445.44 Median $1,737.80 Typical High $1,949.84 | Facility | None | $1,445.44 | $1,737.80 | $1,949.84 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,584.89 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $5,370.32 Typical High $10,715.19 | Facility | None | $3,162.28 | $5,370.32 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,288.25 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $1,949.84 Typical High $2,511.89 | Professional | 50 · Both sides | $1,698.24 | $1,949.84 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $812.83 Typical High $1,148.15 | Professional | 62 · Two surgeons | $724.44 | $812.83 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $208.93 Typical High $263.03 | Professional | 80 · Assistant surgeon | $177.83 | $208.93 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $181.97 Typical High $234.42 | Professional | AS · PA/NP assist | $154.88 | $181.97 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,089.30 | Facility | None | $1,122.02 | $1,348.96 | $2,089.30 |
CareSource Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,862.09 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,344.23 | Facility | None | $34.67 | $512.86 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,691.53 Typical High $9,120.11 | Professional | None | $1,348.96 | $2,691.53 | $9,120.11 |
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 $1,548.82 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,548.82 | $2,238.72 | $2,951.21 |
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 $724.44 Median $794.33 Typical High $1,023.29 | Professional | 52 · Reduced service | $724.44 | $794.33 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $316.23 Typical High $407.38 | Professional | 53 · Discontinued | $288.40 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,202.26 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,096.48 | $1,202.26 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $239.88 Typical High $309.03 | Professional | 55 · Aftercare only | $218.78 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $158.49 Typical High $204.17 | Professional | 56 · Pre-op care only | $144.54 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,122.02 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,122.02 | $1,445.44 |
Where Kentucky sits
The same service costs 5.2 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· 49th of 51
$1,380
AK $5,623TX $1,072
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.