How much rates vary
Facilitymedian $741 · 10th to 90th $447 to $3,981Professionalmedian $550 · 10th to 90th $447 to $832
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 $549.54 Median $676.08 Typical High $794.33 | Facility | None | $549.54 | $676.08 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $691.83 | Professional | None | $549.54 | $562.34 | $691.83 |
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 $446.68 Median $549.54 Typical High $831.76 | Professional | None | $446.68 | $549.54 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $346.74 Typical High $524.81 | Professional | 62 · Two surgeons | $275.42 | $346.74 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $87.10 Typical High $131.83 | Professional | 80 · Assistant surgeon | $70.79 | $87.10 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $75.86 Typical High $114.82 | Professional | AS · PA/NP assist | $61.66 | $75.86 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $831.76 | Facility | None | $446.68 | $537.03 | $831.76 |
CareSource Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $870.96 | Professional | None | $512.86 | $660.69 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $758.58 Typical High $954.99 | Facility | None | $34.67 | $758.58 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $3,548.13 | Professional | None | $537.03 | $616.60 | $3,548.13 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $851.14 | Professional | None | $512.86 | $691.83 | $851.14 |
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 $275.42 Median $281.84 Typical High $346.74 | Professional | 52 · Reduced service | $275.42 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $138.04 | Professional | 53 · Discontinued | $109.65 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $416.87 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $83.18 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $69.18 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $389.05 | $398.11 | $489.78 |
Where Kentucky sits
The same service costs 5.5 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· 45th of 51
$550
AK $2,188TX $398
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.