How much rates vary
Facilitymedian $1,660 · 10th to 90th $832 to $8,913Professionalmedian $1,380 · 10th to 90th $977 to $2,291
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 $851.14 Median $1,513.56 Typical High $8,511.38 | Facility | None | $851.14 | $1,513.56 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,445.44 | $1,819.70 |
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 $977.24 Median $1,288.25 Typical High $1,737.80 | Professional | None | $977.24 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,905.46 Typical High $2,630.27 | Professional | 50 · Both sides | $1,445.44 | $1,905.46 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $812.83 Typical High $1,096.48 | Professional | 62 · Two surgeons | $616.60 | $812.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $204.17 Typical High $275.42 | Professional | 80 · Assistant surgeon | $154.88 | $204.17 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $177.83 Typical High $245.47 | Professional | AS · PA/NP assist | $134.90 | $177.83 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,659.59 | Facility | None | $891.25 | $1,071.52 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,445.44 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,819.70 Typical High $3,801.89 | Facility | None | $34.67 | $1,819.70 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $7,585.78 | Professional | None | $1,071.52 | $2,238.72 | $7,585.78 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,737.80 | $2,290.87 |
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 $575.44 Median $630.96 Typical High $812.83 | Professional | 52 · Reduced service | $575.44 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $323.59 | Professional | 53 · Discontinued | $229.09 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $954.99 Typical High $1,230.27 | Professional | 54 · Surgery only | $851.14 | $954.99 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $245.47 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $162.18 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $891.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $794.33 | $891.25 | $1,148.15 |
Where Kentucky sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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 $12,595KY $3,040
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.