How much rates vary
Facilitymedian $1,288 · 10th to 90th $741 to $6,607Professionalmedian $933 · 10th to 90th $759 to $1,862
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 $977.24 Median $1,202.26 Typical High $1,288.25 | Facility | None | $977.24 | $1,202.26 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,548.82 | Professional | None | $977.24 | $1,071.52 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,230.27 | Professional | None | $758.58 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $562.34 Typical High $758.58 | Professional | 62 · Two surgeons | $478.63 | $562.34 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $141.25 Typical High $190.55 | Professional | 80 · Assistant surgeon | $120.23 | $141.25 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $123.03 Typical High $165.96 | Professional | AS · PA/NP assist | $104.71 | $123.03 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $912.01 Typical High $1,412.54 | Facility | None | $758.58 | $912.01 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $1,445.44 | Professional | None | $812.83 | $1,230.27 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,584.89 Typical High $1,949.84 | Facility | None | $34.67 | $1,584.89 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,862.09 Typical High $6,165.95 | Professional | None | $912.01 | $1,862.09 | $6,165.95 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,513.56 | $1,995.26 |
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 $489.78 Median $537.03 Typical High $691.83 | Professional | 52 · Reduced service | $489.78 | $537.03 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $213.80 Typical High $275.42 | Professional | 53 · Discontinued | $194.98 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $1,023.29 | Professional | 54 · Surgery only | $724.44 | $812.83 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $162.18 Typical High $204.17 | Professional | 55 · Aftercare only | $144.54 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $107.15 Typical High $138.04 | Professional | 56 · Pre-op care only | $97.72 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $954.99 |
Where Kentucky sits
The same service costs 4.6 times more in Wisconsin 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· 50th of 51
$977
WI $3,981TX $871
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.