How much rates vary
Facilitymedian $1,698 · 10th to 90th $457 to $11,220Professionalmedian $1,047 · 10th to 90th $871 to $1,479
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 $977.24 Median $1,174.90 Typical High $1,230.27 | Facility | None | $977.24 | $1,174.90 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,230.27 | Professional | None | $977.24 | $1,000.00 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $10,000.00 Typical High $16,218.10 | Facility | None | $6,025.60 | $10,000.00 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,479.11 | Professional | None | $870.96 | $1,047.13 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $660.69 Typical High $933.25 | Professional | 62 · Two surgeons | $549.54 | $660.69 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $165.96 Typical High $234.42 | Professional | 80 · Assistant surgeon | $138.04 | $165.96 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $147.91 Typical High $208.93 | Professional | AS · PA/NP assist | $120.23 | $147.91 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $933.25 Typical High $1,479.11 | Facility | None | $794.33 | $933.25 | $1,479.11 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,479.11 | Professional | None | $831.76 | $1,148.15 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,698.24 | Facility | None | $34.67 | $691.83 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $6,165.95 | Professional | None | $954.99 | $1,174.90 | $6,165.95 |
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 $933.25 Median $1,288.25 Typical High $1,621.81 | Professional | None | $933.25 | $1,288.25 | $1,621.81 |
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 $489.78 Median $501.19 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $245.47 | Professional | 53 · Discontinued | $194.98 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $933.25 | Professional | 54 · Surgery only | $724.44 | $741.31 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $186.21 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $123.03 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $870.96 |
Where Kentucky sits
The same service costs 24.5 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
$1,047
AK $4,074TX $166
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.