How much rates vary
Facilitymedian $1,622 · 10th to 90th $741 to $6,607Professionalmedian $1,175 · 10th to 90th $955 to $2,344
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 $1,348.96 Median $1,479.11 Typical High $1,778.28 | Facility | None | $1,348.96 | $1,479.11 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,479.11 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,513.56 | Professional | None | $933.25 | $1,122.02 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $707.95 Typical High $954.99 | Professional | 62 · Two surgeons | $602.56 | $707.95 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $234.42 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $208.93 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,949.84 | Facility | None | $1,047.13 | $1,230.27 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,698.24 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,137.96 Typical High $3,801.89 | Facility | None | $34.67 | $2,137.96 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $2,454.71 Typical High $7,762.47 | Professional | None | $1,258.93 | $2,454.71 | $7,762.47 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,905.46 | $2,630.27 |
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 $676.08 Median $724.44 Typical High $954.99 | Professional | 52 · Reduced service | $676.08 | $724.44 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $380.19 | Professional | 53 · Discontinued | $269.15 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $288.40 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $190.55 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,348.96 |
Where Kentucky sits
The same service costs 6.6 times more in Alabama 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
AL $18,462KY $2,797
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.