How much rates vary
Facilitymedian $1,148 · 10th to 90th $457 to $7,244Professionalmedian $1,259 · 10th to 90th $933 to $2,042
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 $1,148.15 Median $1,258.93 Typical High $1,548.82 | Facility | None | $1,148.15 | $1,258.93 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,230.27 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $9,120.11 | Facility | None | $741.31 | $1,047.13 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,548.82 | Professional | None | $912.01 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $724.44 Typical High $977.24 | Professional | 62 · Two surgeons | $575.44 | $724.44 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $181.97 Typical High $251.19 | Professional | 80 · Assistant surgeon | $147.91 | $181.97 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $158.49 Typical High $218.78 | Professional | AS · PA/NP assist | $128.82 | $158.49 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,698.24 | Facility | None | $891.25 | $1,071.52 | $1,698.24 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,479.11 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,905.46 | Facility | None | $34.67 | $512.86 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $2,041.74 Typical High $6,606.93 | Professional | None | $1,071.52 | $2,041.74 | $6,606.93 |
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 $1,174.90 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,548.82 | $2,187.76 |
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 $616.60 Typical High $794.33 | Professional | 52 · Reduced service | $575.44 | $616.60 | $794.33 |
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 $870.96 Median $933.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $239.88 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $158.49 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $1,122.02 |
Where Kentucky sits
The same service costs 9.9 times more in Alabama than in Maryland. 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 $18,241MD $1,851
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.