How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $8,511Professionalmedian $1,259 · 10th to 90th $1,000 to $1,862
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 $1,318.26 Typical High $1,584.89 | Facility | None | $1,258.93 | $1,318.26 | $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 $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 $1,000.00 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,202.26 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $758.58 Typical High $954.99 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $239.88 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $169.82 Typical High $213.80 | Professional | AS · PA/NP assist | $138.04 | $169.82 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,905.46 | Facility | None | $1,023.29 | $1,230.27 | $1,905.46 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,479.11 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,089.30 | Facility | None | $34.67 | $691.83 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $6,760.83 | Professional | None | $1,230.27 | $1,445.44 | $6,760.83 |
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 $1,174.90 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,621.81 | $2,041.74 |
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 $630.96 Typical High $794.33 | Professional | 52 · Reduced service | $630.96 | $630.96 | $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 $1,202.26 | Professional | 54 · Surgery only | $933.25 | $954.99 | $1,202.26 |
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 $1,122.02 | Professional | 78 · Unplanned return to OR | $870.96 | $891.25 | $1,122.02 |
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
$1,259
AK $4,571TX $851
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.