How much rates vary
Facilitymedian $4,365 · 10th to 90th $457 to $11,220Professionalmedian $3,631 · 10th to 90th $2,754 to $5,888
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 $2,290.87 Median $4,365.16 Typical High $5,495.41 | Facility | None | $2,290.87 | $4,365.16 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,466.84 Typical High $5,495.41 | Professional | None | $4,265.80 | $4,466.84 | $5,495.41 |
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 $2,691.53 Median $3,311.31 Typical High $3,890.45 | Professional | None | $2,691.53 | $3,311.31 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,698.24 Median $2,089.30 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,698.24 | $2,089.30 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $537.03 Typical High $630.96 | Professional | 80 · Assistant surgeon | $426.58 | $537.03 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $467.74 Typical High $549.54 | Professional | AS · PA/NP assist | $380.19 | $467.74 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $3,467.37 Median $4,168.69 Typical High $6,606.93 | Facility | None | $3,467.37 | $4,168.69 | $6,606.93 |
CareSource Setting Professional Modifier None Typical Low $3,715.35 Median $5,128.61 Typical High $6,606.93 | Professional | None | $3,715.35 | $5,128.61 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $7,413.10 | Facility | None | $34.67 | $512.86 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $19,952.62 | Professional | None | $4,265.80 | $4,786.30 | $19,952.62 |
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 $3,801.89 Median $5,370.32 Typical High $6,760.83 | Professional | None | $3,801.89 | $5,370.32 | $6,760.83 |
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 $2,137.96 Median $2,238.72 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,137.96 | $2,238.72 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $891.25 Typical High $1,096.48 | Professional | 53 · Discontinued | $851.14 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,311.31 Typical High $4,073.80 | Professional | 54 · Surgery only | $3,162.28 | $3,311.31 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $660.69 Typical High $831.76 | Professional | 55 · Aftercare only | $630.96 | $660.69 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $446.68 Typical High $549.54 | Professional | 56 · Pre-op care only | $426.58 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $3,090.30 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $2,951.21 | $3,090.30 | $3,801.89 |
Where Kentucky sits
The same service costs 21.9 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· 47th of 51
$3,631
AK $15,136TX $692
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.