How much rates vary
Facilitymedian $2,344 · 10th to 90th $741 to $8,511Professionalmedian $631 · 10th to 90th $525 to $912
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 $588.84 Median $741.31 Typical High $8,511.38 | Facility | None | $588.84 | $741.31 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $741.31 | Professional | None | $588.84 | $602.56 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $870.96 | Professional | None | $524.81 | $630.96 | $870.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $398.11 Typical High $549.54 | Professional | 62 · Two surgeons | $331.13 | $398.11 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $102.33 Typical High $138.04 | Professional | 80 · Assistant surgeon | $83.18 | $102.33 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $89.13 Typical High $120.23 | Professional | AS · PA/NP assist | $74.13 | $89.13 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $2,344.23 | Facility | None | $549.54 | $891.25 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $891.25 | Professional | None | $501.19 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,659.59 Typical High $2,290.87 | Facility | None | $741.31 | $1,659.59 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $3,630.78 | Professional | None | $575.44 | $707.95 | $3,630.78 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,000.00 | Professional | None | $549.54 | $794.33 | $1,000.00 |
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 $288.40 Median $302.00 Typical High $371.54 | Professional | 52 · Reduced service | $288.40 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $446.68 Typical High $549.54 | Professional | 54 · Surgery only | $436.52 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $91.20 Typical High $109.65 | Professional | 55 · Aftercare only | $87.10 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $60.26 Typical High $74.13 | Professional | 56 · Pre-op care only | $58.88 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $416.87 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $407.38 | $416.87 | $512.86 |
Where Kentucky sits
The same service costs 6.5 times more in Alaska than in Texas. 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· 42nd of 51
$631
AK $2,455TX $380
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.