How much rates vary
Facilitymedian $2,188 · 10th to 90th $389 to $8,511Professionalmedian $2,570 · 10th to 90th $1,862 to $4,169
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 $2,187.76 Median $2,511.89 Typical High $2,884.03 | Facility | None | $2,187.76 | $2,511.89 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $3,467.37 | Professional | None | $2,187.76 | $2,511.89 | $3,467.37 |
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 $1,862.09 Median $2,398.83 Typical High $3,090.30 | Professional | None | $1,862.09 | $2,398.83 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,513.56 Typical High $1,949.84 | Professional | 62 · Two surgeons | $1,174.90 | $1,513.56 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $380.19 Typical High $489.78 | Professional | 80 · Assistant surgeon | $295.12 | $380.19 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $338.84 Typical High $426.58 | Professional | AS · PA/NP assist | $263.03 | $338.84 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $3,162.28 | Facility | None | $1,698.24 | $2,041.74 | $3,162.28 |
CareSource Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,187.76 | $2,754.23 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $3,467.37 | Facility | None | $34.67 | $691.83 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $3,981.07 Typical High $13,182.57 | Professional | None | $2,041.74 | $3,981.07 | $13,182.57 |
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 $2,398.83 Median $3,235.94 Typical High $4,365.16 | Professional | None | $2,398.83 | $3,235.94 | $4,365.16 |
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 $1,096.48 Median $1,202.26 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,096.48 | $1,202.26 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $478.63 Typical High $616.60 | Professional | 53 · Discontinued | $436.52 | $478.63 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,819.70 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,621.81 | $1,819.70 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $363.08 Typical High $457.09 | Professional | 55 · Aftercare only | $323.59 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $239.88 Typical High $309.03 | Professional | 56 · Pre-op care only | $218.78 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,698.24 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,698.24 | $2,137.96 |
Where Kentucky sits
The same service costs 7.3 times more in Alaska than in Washington. 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.
Physician feeFacility fee
AK $20,260WA $2,785
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.