How much rates vary
Facilitymedian $692 · 10th to 90th $324 to $2,512Professionalmedian $513 · 10th to 90th $380 to $933
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 $436.52 Median $524.81 Typical High $794.33 | Facility | None | $436.52 | $524.81 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $831.76 | Professional | None | $524.81 | $562.34 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $645.65 | Professional | None | $371.54 | $446.68 | $645.65 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $281.84 Typical High $407.38 | Professional | 62 · Two surgeons | $234.42 | $281.84 | $407.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $72.44 Typical High $97.72 | Professional | 80 · Assistant surgeon | $58.88 | $72.44 | $97.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $63.10 Typical High $89.13 | Professional | AS · PA/NP assist | $51.29 | $63.10 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $478.63 Typical High $758.58 | Facility | None | $398.11 | $478.63 | $758.58 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $776.25 | Professional | None | $524.81 | $660.69 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $812.83 Typical High $1,949.84 | Facility | None | $34.67 | $812.83 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $891.25 Typical High $2,238.72 | Professional | None | $489.78 | $891.25 | $2,238.72 |
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 $323.59 Median $588.84 Typical High $1,621.81 | Facility | None | $323.59 | $588.84 | $1,621.81 |
United Setting Professional Modifier None Typical Low $501.19 Median $741.31 Typical High $1,023.29 | Professional | None | $501.19 | $741.31 | $1,023.29 |
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 $263.03 Median $281.84 Typical High $380.19 | Professional | 52 · Reduced service | $263.03 | $281.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $151.36 | Professional | 53 · Discontinued | $104.71 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $575.44 | Professional | 54 · Surgery only | $389.05 | $426.58 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $114.82 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $75.86 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $398.11 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $363.08 | $398.11 | $537.03 |
Where Kentucky sits
The same service costs 4.9 times more in Alaska than in West Virginia. 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 $5,557WV $1,144
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.