How much rates vary
Facilitymedian $2,512 · 10th to 90th $832 to $11,220Professionalmedian $1,288 · 10th to 90th $1,096 to $2,042
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 $1,445.44 Median $1,479.11 Typical High $1,862.09 | Facility | None | $1,445.44 | $1,479.11 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,513.56 | $1,862.09 |
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 $1,071.52 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,258.93 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $912.01 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $234.42 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $204.17 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,238.72 | Facility | None | $1,202.26 | $1,445.44 | $2,238.72 |
CareSource Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,778.28 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,511.89 | Facility | None | $34.67 | $512.86 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $7,413.10 | Professional | None | $1,445.44 | $1,659.59 | $7,413.10 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,949.84 | $2,398.83 |
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 $724.44 Median $758.58 Typical High $933.25 | Professional | 52 · Reduced service | $724.44 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $371.54 | Professional | 53 · Discontinued | $288.40 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,148.15 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,096.48 | $1,148.15 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $281.84 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $186.21 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,071.52 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,071.52 | $1,318.26 |
Where Kentucky sits
The same service costs 6.3 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· 49th of 51
$1,288
AK $6,166TX $977
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.