How much rates vary
Facilitymedian $1,318 · 10th to 90th $389 to $8,511Professionalmedian $1,445 · 10th to 90th $1,096 to $2,291
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 $1,258.93 Median $1,318.26 Typical High $1,698.24 | Facility | None | $1,258.93 | $1,318.26 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,380.38 | $1,995.26 |
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 $1,047.13 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,995.26 Typical High $2,691.53 | Professional | 50 · Both sides | $1,548.82 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $831.76 Typical High $1,148.15 | Professional | 62 · Two surgeons | $660.69 | $831.76 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $288.40 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $186.21 Typical High $251.19 | Professional | AS · PA/NP assist | $144.54 | $186.21 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,862.09 | Facility | None | $977.24 | $1,174.90 | $1,862.09 |
CareSource Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,621.81 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,137.96 | Facility | None | $34.67 | $691.83 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $6,918.31 | Professional | None | $1,174.90 | $2,290.87 | $6,918.31 |
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 $1,380.38 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,819.70 | $2,511.89 |
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 $630.96 Median $691.83 Typical High $912.01 | Professional | 52 · Reduced service | $630.96 | $691.83 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $363.08 | Professional | 53 · Discontinued | $251.19 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,348.96 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $208.93 Typical High $275.42 | Professional | 55 · Aftercare only | $190.55 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $181.97 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $954.99 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $891.25 | $954.99 | $1,258.93 |
Where Kentucky sits
The same service costs 4.8 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· 41st of 51
$1,445
AK $5,012TX $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.