How much rates vary
Facilitymedian $2,089 · 10th to 90th $457 to $9,772Professionalmedian $1,585 · 10th to 90th $1,230 to $2,344
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 $1,659.59 Median $1,737.80 Typical High $2,089.30 | Facility | None | $1,659.59 | $1,737.80 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,659.59 | $1,698.24 | $2,089.30 |
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 $1,202.26 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,445.44 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $912.01 Typical High $1,148.15 | Professional | 62 · Two surgeons | $758.58 | $912.01 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $229.09 Typical High $288.40 | Professional | 80 · Assistant surgeon | $190.55 | $229.09 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $199.53 Typical High $251.19 | Professional | AS · PA/NP assist | $165.96 | $199.53 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,511.89 | Facility | None | $1,348.96 | $1,621.81 | $2,511.89 |
CareSource Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,995.26 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,818.38 | Facility | None | $34.67 | $512.86 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $9,120.11 | Professional | None | $1,621.81 | $1,862.09 | $9,120.11 |
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 $1,548.82 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,548.82 | $2,089.30 | $2,630.27 |
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 $831.76 Median $851.14 Typical High $1,047.13 | Professional | 52 · Reduced service | $831.76 | $851.14 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $416.87 | Professional | 53 · Discontinued | $331.13 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,288.25 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,258.93 | $1,288.25 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $257.04 Typical High $316.23 | Professional | 55 · Aftercare only | $251.19 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $208.93 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,202.26 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,202.26 | $1,479.11 |
Where Kentucky sits
The same service costs 5.4 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· 46th of 51
$1,622
AK $5,888TX $1,096
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.