How much rates vary
Facilitymedian $1,514 · 10th to 90th $832 to $8,511Professionalmedian $1,096 · 10th to 90th $851 to $2,042
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 $1,023.29 Median $1,348.96 Typical High $1,380.38 | Facility | None | $1,023.29 | $1,348.96 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,445.44 | Professional | None | $851.14 | $1,023.29 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,548.82 Typical High $2,137.96 | Professional | 50 · Both sides | $1,258.93 | $1,548.82 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $645.65 Typical High $912.01 | Professional | 62 · Two surgeons | $537.03 | $645.65 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $165.96 Typical High $229.09 | Professional | 80 · Assistant surgeon | $134.90 | $165.96 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $144.54 Typical High $199.53 | Professional | AS · PA/NP assist | $117.49 | $144.54 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $1,513.56 | Facility | None | $794.33 | $954.99 | $1,513.56 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $1,548.82 | Professional | None | $912.01 | $1,318.26 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,659.59 Typical High $3,801.89 | Facility | None | $34.67 | $1,659.59 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $2,041.74 Typical High $7,079.46 | Professional | None | $954.99 | $2,041.74 | $7,079.46 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,621.81 | $2,137.96 |
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 $512.86 Median $562.34 Typical High $724.44 | Professional | 52 · Reduced service | $512.86 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $229.09 Typical High $288.40 | Professional | 53 · Discontinued | $204.17 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $1,096.48 | Professional | 54 · Surgery only | $776.25 | $851.14 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $169.82 Typical High $218.78 | Professional | 55 · Aftercare only | $154.88 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $114.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $102.33 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $794.33 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $724.44 | $794.33 | $1,023.29 |
Where Kentucky sits
The same service costs 5.1 times more in Wisconsin 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· 47th of 51
$1,175
WI $4,677TX $912
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.