How much rates vary
Facilitymedian $1,514 · 10th to 90th $380 to $8,511Professionalmedian $1,660 · 10th to 90th $1,259 to $2,630
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 $1,513.56 Typical High $1,949.84 | Facility | None | $1,445.44 | $1,513.56 | $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 $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 $1,202.26 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,513.56 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,290.87 Typical High $2,884.03 | Professional | 50 · Both sides | $1,819.70 | $2,290.87 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $954.99 Typical High $1,230.27 | Professional | 62 · Two surgeons | $758.58 | $954.99 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $245.47 Typical High $309.03 | Professional | 80 · Assistant surgeon | $190.55 | $245.47 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $213.80 Typical High $269.15 | Professional | AS · PA/NP assist | $169.82 | $213.80 | $269.15 |
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 $691.83 Typical High $2,454.71 | Facility | None | $34.67 | $691.83 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,570.40 Typical High $7,943.28 | Professional | None | $1,348.96 | $2,570.40 | $7,943.28 |
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 $2,041.74 Typical High $2,818.38 | Professional | None | $1,548.82 | $2,041.74 | $2,818.38 |
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 $1,047.13 | Professional | 52 · Reduced service | $724.44 | $794.33 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $316.23 Typical High $416.87 | Professional | 53 · Discontinued | $288.40 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,174.90 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,096.48 | $1,174.90 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $234.42 Typical High $309.03 | Professional | 55 · Aftercare only | $218.78 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $158.49 Typical High $208.93 | Professional | 56 · Pre-op care only | $144.54 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,096.48 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,096.48 | $1,445.44 |
Where Kentucky sits
The same service costs 5.6 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· 38th of 51
$1,660
AK $5,754TX $1,023
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.