How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $11,220Professionalmedian $1,318 · 10th to 90th $1,023 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 $1,380.38 Median $1,412.54 Typical High $1,778.28 | Facility | None | $1,380.38 | $1,412.54 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,445.44 | $1,778.28 |
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 $1,000.00 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,202.26 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $758.58 Typical High $954.99 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $245.47 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $213.80 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,137.96 | Facility | None | $1,148.15 | $1,380.38 | $2,137.96 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,621.81 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,454.71 | Facility | None | $34.67 | $512.86 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $7,079.46 | Professional | None | $1,380.38 | $1,621.81 | $7,079.46 |
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 $1,318.26 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,862.09 | $2,290.87 |
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 $691.83 Median $724.44 Typical High $891.25 | Professional | 52 · Reduced service | $691.83 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $288.40 Typical High $354.81 | Professional | 53 · Discontinued | $275.42 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,071.52 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,047.13 | $1,071.52 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $213.80 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $144.54 Typical High $177.83 | Professional | 56 · Pre-op care only | $138.04 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,000.00 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $977.24 | $1,000.00 | $1,258.93 |
Where Kentucky sits
The same service costs 5.0 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· 48th of 51
$1,349
AK $5,012TX $1,000
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.