How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $8,511Professionalmedian $1,479 · 10th to 90th $1,175 to $2,188
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 $1,659.59 Typical High $1,905.46 | Facility | None | $1,479.11 | $1,659.59 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,479.11 | $1,513.56 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,677.35 Typical High $10,715.19 | Facility | None | $2,754.23 | $4,677.35 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,412.54 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $891.25 Typical High $1,122.02 | Professional | 62 · Two surgeons | $741.31 | $891.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $281.84 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $199.53 Typical High $245.47 | Professional | AS · PA/NP assist | $162.18 | $199.53 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,445.44 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,778.28 | $2,290.87 |
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 $1,778.28 Typical High $8,709.64 | Professional | None | $1,445.44 | $1,778.28 | $8,709.64 |
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 $1,412.54 Median $1,949.84 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,949.84 | $2,454.71 |
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 $954.99 | Professional | 52 · Reduced service | $741.31 | $758.58 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $380.19 | Professional | 53 · Discontinued | $302.00 | $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 $190.55 | Professional | 56 · Pre-op care only | $147.91 | $151.36 | $190.55 |
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 22.9 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· 45th of 51
$1,479
AK $5,495TX $240
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.