How much rates vary
Facilitymedian $2,754 · 10th to 90th $457 to $8,913Professionalmedian $1,738 · 10th to 90th $1,413 to $3,631
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 $1,412.54 Median $2,089.30 Typical High $2,818.38 | Facility | None | $1,412.54 | $2,089.30 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $3,019.95 | Professional | None | $2,089.30 | $2,290.87 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $5,370.32 Typical High $10,715.19 | Facility | None | $3,162.28 | $5,370.32 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,659.59 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,511.89 Typical High $3,467.37 | Professional | 50 · Both sides | $2,089.30 | $2,511.89 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,047.13 Typical High $1,445.44 | Professional | 62 · Two surgeons | $891.25 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $263.03 Typical High $371.54 | Professional | 80 · Assistant surgeon | $223.87 | $263.03 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $234.42 Typical High $323.59 | Professional | AS · PA/NP assist | $194.98 | $234.42 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $3,019.95 | Facility | None | $1,621.81 | $1,949.84 | $3,019.95 |
CareSource Setting Professional Modifier None Typical Low $1,737.80 Median $2,691.53 Typical High $3,162.28 | Professional | None | $1,737.80 | $2,691.53 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,388.44 | Facility | None | $34.67 | $512.86 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $3,630.78 Typical High $9,120.11 | Professional | None | $1,995.26 | $3,630.78 | $9,120.11 |
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 $1,737.80 Median $2,951.21 Typical High $4,073.80 | Professional | None | $1,737.80 | $2,951.21 | $4,073.80 |
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 $1,047.13 Median $1,148.15 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,047.13 | $1,148.15 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $467.74 Typical High $602.56 | Professional | 53 · Discontinued | $416.87 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,737.80 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,548.82 | $1,737.80 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $346.74 Typical High $457.09 | Professional | 55 · Aftercare only | $309.03 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $229.09 Typical High $302.00 | Professional | 56 · Pre-op care only | $208.93 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,621.81 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,621.81 | $2,137.96 |
Where Kentucky sits
The same service costs 7.2 times more in Alabama 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
AL $19,737WA $2,745
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.