How much rates vary
Facilitymedian $2,754 · 10th to 90th $457 to $8,511Professionalmedian $1,950 · 10th to 90th $1,549 to $2,951
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 $2,187.76 Median $2,238.72 Typical High $2,818.38 | Facility | None | $2,187.76 | $2,238.72 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,290.87 | $2,818.38 |
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 $1,513.56 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,513.56 | $1,819.70 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,148.15 Typical High $1,445.44 | Professional | 62 · Two surgeons | $954.99 | $1,148.15 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $288.40 Typical High $363.08 | Professional | 80 · Assistant surgeon | $239.88 | $288.40 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $257.04 Typical High $316.23 | Professional | AS · PA/NP assist | $208.93 | $257.04 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $3,388.44 | Facility | None | $1,819.70 | $2,137.96 | $3,388.44 |
CareSource Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $3,388.44 | Professional | None | $1,905.46 | $2,570.40 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,801.89 | Facility | None | $34.67 | $512.86 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $11,481.54 | Professional | None | $2,187.76 | $2,398.83 | $11,481.54 |
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 $1,995.26 Median $2,630.27 Typical High $3,311.31 | Professional | None | $1,995.26 | $2,630.27 | $3,311.31 |
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 $1,096.48 Median $1,148.15 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,096.48 | $1,148.15 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $562.34 | Professional | 53 · Discontinued | $446.68 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,698.24 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,659.59 | $1,698.24 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $338.84 Typical High $426.58 | Professional | 55 · Aftercare only | $331.13 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $229.09 Typical High $281.84 | Professional | 56 · Pre-op care only | $218.78 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,584.89 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,584.89 | $1,949.84 |
Where Kentucky sits
The same service costs 20.9 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
$1,950
AK $7,586TX $363
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.