How much rates vary
Facilitymedian $2,089 · 10th to 90th $457 to $8,913Professionalmedian $1,698 · 10th to 90th $1,318 to $2,818
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 $1,584.89 Median $1,862.09 Typical High $2,089.30 | Facility | None | $1,584.89 | $1,862.09 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,584.89 | $1,737.80 | $2,511.89 |
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 $1,318.26 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,584.89 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,398.83 Typical High $3,162.28 | Professional | 50 · Both sides | $1,995.26 | $2,398.83 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,000.00 Typical High $1,318.26 | Professional | 62 · Two surgeons | $831.76 | $1,000.00 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $257.04 Typical High $331.13 | Professional | 80 · Assistant surgeon | $208.93 | $257.04 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $223.87 Typical High $295.12 | Professional | AS · PA/NP assist | $186.21 | $223.87 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,445.44 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $1,380.38 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,995.26 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,630.27 | Facility | None | $34.67 | $691.83 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,818.38 Typical High $9,772.37 | Professional | None | $1,479.11 | $2,818.38 | $9,772.37 |
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 $1,698.24 Median $2,238.72 Typical High $3,090.30 | Professional | None | $1,698.24 | $2,238.72 | $3,090.30 |
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 $776.25 Median $851.14 Typical High $1,122.02 | Professional | 52 · Reduced service | $776.25 | $851.14 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $346.74 Typical High $446.68 | Professional | 53 · Discontinued | $316.23 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,288.25 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,174.90 | $1,288.25 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $257.04 Typical High $338.84 | Professional | 55 · Aftercare only | $234.42 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $173.78 Typical High $223.87 | Professional | 56 · Pre-op care only | $158.49 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,202.26 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,202.26 | $1,584.89 |
Where Kentucky sits
The same service costs 5.2 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· 42nd of 51
$1,698
AK $6,166TX $1,175
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.