How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $9,772Professionalmedian $1,288 · 10th to 90th $1,047 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 $1,479.11 Median $1,548.82 Typical High $1,862.09 | Facility | None | $1,479.11 | $1,548.82 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,513.56 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $6,025.60 Typical High $11,220.18 | Facility | None | $3,548.13 | $6,025.60 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,258.93 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $776.25 Typical High $933.25 | Professional | 62 · Two surgeons | $660.69 | $776.25 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $239.88 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $208.93 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $208.93 |
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 $1,412.54 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,778.28 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,511.89 | Facility | None | $34.67 | $691.83 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $7,943.28 | Professional | None | $1,445.44 | $1,659.59 | $7,943.28 |
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 $1,380.38 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,862.09 | $2,344.23 |
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 $741.31 Median $758.58 Typical High $933.25 | Professional | 52 · Reduced service | $741.31 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $302.00 Typical High $380.19 | Professional | 53 · Discontinued | $295.12 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,148.15 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,148.15 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $151.36 Typical High $186.21 | Professional | 56 · Pre-op care only | $147.91 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,318.26 |
Where Kentucky sits
The same service costs 20.9 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
$1,288
AK $5,129TX $245
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.