How much rates vary
Facilitymedian $2,291 · 10th to 90th $759 to $8,318Professionalmedian $708 · 10th to 90th $550 to $1,047
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 $645.65 Median $812.83 Typical High $1,023.29 | Facility | None | $645.65 | $812.83 | $1,023.29 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,023.29 | Professional | None | $645.65 | $812.83 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,071.52 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $912.01 | Professional | None | $524.81 | $676.08 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $109.65 Typical High $144.54 | Professional | 80 · Assistant surgeon | $85.11 | $109.65 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $95.50 Typical High $128.82 | Professional | AS · PA/NP assist | $74.13 | $95.50 | $128.82 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $1,000.00 Typical High $4,897.79 | Facility | None | $524.81 | $1,000.00 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,000.00 | Professional | None | $549.54 | $776.25 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,290.87 Typical High $3,630.78 | Facility | None | $1,023.29 | $2,290.87 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $4,073.80 | Professional | None | $630.96 | $812.83 | $4,073.80 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,174.90 | Professional | None | $676.08 | $933.25 | $1,174.90 |
12 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 Facility Modifier 52 · Reduced service Typical Low $323.59 Median $407.38 Typical High $512.86 | Facility | 52 · Reduced service | $323.59 | $407.38 | $512.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $128.82 Median $162.18 Typical High $204.17 | Facility | 53 · Discontinued | $128.82 | $162.18 | $204.17 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $489.78 Median $616.60 Typical High $776.25 | Facility | 54 · Surgery only | $489.78 | $616.60 | $776.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $97.72 Median $123.03 Typical High $154.88 | Facility | 55 · Aftercare only | $97.72 | $123.03 | $154.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $64.57 Median $81.28 Typical High $102.33 | Facility | 56 · Pre-op care only | $64.57 | $81.28 | $102.33 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $575.44 Typical High $724.44 | Facility | 78 · Unplanned return to OR | $457.09 | $575.44 | $724.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $407.38 Typical High $512.86 | Professional | 52 · Reduced service | $323.59 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $162.18 Typical High $204.17 | Professional | 53 · Discontinued | $128.82 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $616.60 Typical High $776.25 | Professional | 54 · Surgery only | $489.78 | $616.60 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $123.03 Typical High $154.88 | Professional | 55 · Aftercare only | $97.72 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $81.28 Typical High $102.33 | Professional | 56 · Pre-op care only | $64.57 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $575.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $457.09 | $575.44 | $724.44 |
Where Kentucky sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 47th of 51
$724
AK $2,754NJ $631
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.