How much rates vary
Facilitymedian $2,754 · 10th to 90th $457 to $8,511Professionalmedian $2,291 · 10th to 90th $1,778 to $3,388
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 $2,454.71 Median $2,511.89 Typical High $3,090.30 | Facility | None | $2,454.71 | $2,511.89 | $3,090.30 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,454.71 | $2,511.89 | $3,090.30 |
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 $1,778.28 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,089.30 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,318.26 Typical High $1,659.59 | Professional | 62 · Two surgeons | $1,122.02 | $1,318.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $331.13 Typical High $416.87 | Professional | 80 · Assistant surgeon | $281.84 | $331.13 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $295.12 Typical High $363.08 | Professional | AS · PA/NP assist | $245.47 | $295.12 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $3,715.35 | Facility | None | $1,949.84 | $2,344.23 | $3,715.35 |
CareSource Setting Professional Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $3,715.35 | Professional | None | $2,089.30 | $2,754.23 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $4,168.69 | Facility | None | $34.67 | $512.86 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $12,882.50 | Professional | None | $2,398.83 | $2,630.27 | $12,882.50 |
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 $2,187.76 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,884.03 | $3,801.89 |
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 $1,230.27 Median $1,258.93 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,230.27 | $1,258.93 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $501.19 Typical High $616.60 | Professional | 53 · Discontinued | $489.78 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,862.09 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,819.70 | $1,862.09 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $371.54 Typical High $467.74 | Professional | 55 · Aftercare only | $363.08 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $251.19 Typical High $309.03 | Professional | 56 · Pre-op care only | $245.47 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,737.80 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,737.80 | $2,137.96 |
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
$2,344
AK $8,710TX $1,622
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.