How much rates vary
Facilitymedian $2,138 · 10th to 90th $759 to $9,550Professionalmedian $1,230 · 10th to 90th $977 to $1,738
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 $1,258.93 Median $1,380.38 Typical High $1,584.89 | Facility | None | $1,258.93 | $1,380.38 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,288.25 | $1,584.89 |
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 $954.99 Median $1,148.15 Typical High $1,445.44 | Professional | None | $954.99 | $1,148.15 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $724.44 Typical High $912.01 | Professional | 62 · Two surgeons | $602.56 | $724.44 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $186.21 Typical High $234.42 | Professional | 80 · Assistant surgeon | $151.36 | $186.21 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $162.18 Typical High $204.17 | Professional | AS · PA/NP assist | $134.90 | $162.18 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,905.46 | Facility | None | $1,023.29 | $1,202.26 | $1,905.46 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,479.11 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,137.96 | Facility | None | $34.67 | $691.83 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $7,244.36 | Professional | None | $1,230.27 | $1,380.38 | $7,244.36 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,548.82 | $1,949.84 |
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 $630.96 Median $645.65 Typical High $794.33 | Professional | 52 · Reduced service | $630.96 | $645.65 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $316.23 | Professional | 53 · Discontinued | $251.19 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $954.99 Typical High $1,174.90 | Professional | 54 · Surgery only | $933.25 | $954.99 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $190.55 Typical High $239.88 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $158.49 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $891.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $870.96 | $891.25 | $1,096.48 |
Where Kentucky sits
The same service costs 26.3 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· 44th of 51
$1,230
AK $5,248TX $200
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.