How much rates vary
Facilitymedian $1,698 · 10th to 90th $457 to $9,772Professionalmedian $955 · 10th to 90th $759 to $1,349
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 $954.99 Median $1,023.29 Typical High $1,230.27 | Facility | None | $954.99 | $1,023.29 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,230.27 | Professional | None | $954.99 | $1,000.00 | $1,230.27 |
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 $758.58 Median $912.01 Typical High $1,230.27 | Professional | None | $758.58 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $575.44 Typical High $758.58 | Professional | 62 · Two surgeons | $478.63 | $575.44 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $147.91 Typical High $194.98 | Professional | 80 · Assistant surgeon | $120.23 | $147.91 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $128.82 Typical High $169.82 | Professional | AS · PA/NP assist | $104.71 | $128.82 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $1,479.11 | Facility | None | $776.25 | $933.25 | $1,479.11 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,479.11 | Professional | None | $912.01 | $1,148.15 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,698.24 | Facility | None | $34.67 | $512.86 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $5,370.32 | Professional | None | $933.25 | $1,047.13 | $5,370.32 |
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 $891.25 Median $1,148.15 Typical High $1,479.11 | Professional | None | $891.25 | $1,148.15 | $1,479.11 |
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 $478.63 Median $489.78 Typical High $602.56 | Professional | 52 · Reduced service | $478.63 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $245.47 | Professional | 53 · Discontinued | $190.55 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $912.01 | Professional | 54 · Surgery only | $724.44 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $123.03 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $851.14 |
Where Kentucky sits
The same service costs 4.9 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· 46th of 51
$955
AK $3,548TX $724
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.