How much rates vary
Facilitymedian $1,202 · 10th to 90th $380 to $9,772Professionalmedian $617 · 10th to 90th $437 to $1,096
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 $398.11 Median $524.81 Typical High $8,511.38 | Facility | None | $398.11 | $524.81 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $794.33 | Professional | None | $398.11 | $501.19 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $6,025.60 Typical High $11,220.18 | Facility | None | $3,548.13 | $6,025.60 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $812.83 | Professional | None | $501.19 | $602.56 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $912.01 Typical High $1,230.27 | Professional | 50 · Both sides | $741.31 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $380.19 Typical High $512.86 | Professional | 62 · Two surgeons | $302.00 | $380.19 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $97.72 Typical High $128.82 | Professional | 80 · Assistant surgeon | $75.86 | $97.72 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $85.11 Typical High $114.82 | Professional | AS · PA/NP assist | $67.61 | $85.11 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $371.54 Typical High $575.44 | Facility | None | $309.03 | $371.54 | $575.44 |
CareSource Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $588.84 | Professional | None | $331.13 | $501.19 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $645.65 Typical High $794.33 | Facility | None | $34.67 | $645.65 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $1,096.48 Typical High $4,073.80 | Professional | None | $371.54 | $1,096.48 | $4,073.80 |
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 $575.44 Median $851.14 Typical High $1,174.90 | Professional | None | $575.44 | $851.14 | $1,174.90 |
5 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 $199.53 Median $218.78 Typical High $398.11 | Professional | 52 · Reduced service | $199.53 | $218.78 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $158.49 | Professional | 53 · Discontinued | $79.43 | $87.10 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $331.13 Typical High $588.84 | Professional | 54 · Surgery only | $295.12 | $331.13 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $66.07 Typical High $117.49 | Professional | 55 · Aftercare only | $58.88 | $66.07 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $79.43 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $79.43 |
Where Kentucky sits
The same service costs 3.7 times more in Wisconsin than in New York. 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
$646
WI $1,622NY $437
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.