How much rates vary
Facilitymedian $3,162 · 10th to 90th $457 to $11,220Professionalmedian $2,818 · 10th to 90th $2,291 to $4,074
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 $2,818.38 Median $3,162.28 Typical High $3,548.13 | Facility | None | $2,818.38 | $3,162.28 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,818.38 | $2,884.03 | $3,548.13 |
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 $2,290.87 Median $2,818.38 Typical High $3,890.45 | Professional | None | $2,290.87 | $2,818.38 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,778.28 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,445.44 | $1,778.28 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $446.68 Typical High $616.60 | Professional | 80 · Assistant surgeon | $363.08 | $446.68 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $389.05 Typical High $537.03 | Professional | AS · PA/NP assist | $316.23 | $389.05 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $4,265.80 | Facility | None | $2,290.87 | $2,754.23 | $4,265.80 |
CareSource Setting Professional Modifier None Typical Low $2,398.83 Median $3,388.44 Typical High $4,265.80 | Professional | None | $2,398.83 | $3,388.44 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $4,786.30 | Facility | None | $34.67 | $512.86 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $16,595.87 | Professional | None | $2,754.23 | $3,162.28 | $16,595.87 |
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 $2,511.89 Median $3,548.13 Typical High $4,365.16 | Professional | None | $2,511.89 | $3,548.13 | $4,365.16 |
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 $1,412.54 Median $1,445.44 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,412.54 | $1,445.44 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $575.44 Typical High $707.95 | Professional | 53 · Discontinued | $562.34 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,187.76 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,137.96 | $2,187.76 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $436.52 Typical High $537.03 | Professional | 55 · Aftercare only | $426.58 | $436.52 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $288.40 Typical High $354.81 | Professional | 56 · Pre-op care only | $281.84 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,041.74 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,041.74 | $2,511.89 |
Where Kentucky sits
The same service costs 21.4 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· 41st of 51
$2,818
AK $9,772TX $457
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.