How much rates vary
Facilitymedian $1,905 · 10th to 90th $380 to $8,511Professionalmedian $2,344 · 10th to 90th $1,622 to $3,715
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 $1,905.46 Median $2,344.23 Typical High $2,570.40 | Facility | None | $1,905.46 | $2,344.23 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,905.46 | $2,089.30 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $11,220.18 | Facility | None | $758.58 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,621.81 | $2,187.76 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,380.38 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,023.29 | $1,380.38 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $346.74 Typical High $457.09 | Professional | 80 · Assistant surgeon | $257.04 | $346.74 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $302.00 Typical High $398.11 | Professional | AS · PA/NP assist | $223.87 | $302.00 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,754.23 | Facility | None | $1,479.11 | $1,778.28 | $2,754.23 |
CareSource Setting Professional Modifier None Typical Low $1,698.24 Median $2,454.71 Typical High $2,884.03 | Professional | None | $1,698.24 | $2,454.71 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,090.30 | Facility | None | $34.67 | $512.86 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $12,302.69 | Professional | None | $1,778.28 | $3,548.13 | $12,302.69 |
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 $2,238.72 Median $2,951.21 Typical High $3,890.45 | Professional | None | $2,238.72 | $2,951.21 | $3,890.45 |
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 $954.99 Median $1,047.13 Typical High $1,348.96 | Professional | 52 · Reduced service | $954.99 | $1,047.13 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $426.58 Typical High $537.03 | Professional | 53 · Discontinued | $380.19 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,584.89 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,445.44 | $1,584.89 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $407.38 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $208.93 Typical High $269.15 | Professional | 56 · Pre-op care only | $190.55 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,479.11 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,479.11 | $1,905.46 |
Where Kentucky sits
The same service costs 5.1 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
$2,291
AK $7,413TX $1,445
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.