How much rates vary
Facilitymedian $4,074 · 10th to 90th $457 to $8,511Professionalmedian $3,311 · 10th to 90th $2,754 to $5,370
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 $4,073.80 Median $4,265.80 Typical High $5,248.07 | Facility | None | $4,073.80 | $4,265.80 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $5,248.07 | Professional | None | $4,073.80 | $4,168.69 | $5,248.07 |
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 $2,630.27 Median $3,090.30 Typical High $3,630.78 | Professional | None | $2,630.27 | $3,090.30 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $1,949.84 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,659.59 | $1,949.84 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $501.19 Typical High $575.44 | Professional | 80 · Assistant surgeon | $426.58 | $501.19 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $436.52 Typical High $512.86 | Professional | AS · PA/NP assist | $371.54 | $436.52 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $3,311.31 Median $3,981.07 Typical High $6,309.57 | Facility | None | $3,311.31 | $3,981.07 | $6,309.57 |
CareSource Setting Professional Modifier None Typical Low $3,548.13 Median $4,897.79 Typical High $6,309.57 | Professional | None | $3,548.13 | $4,897.79 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $6,918.31 | Facility | None | $34.67 | $691.83 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $3,981.07 Median $4,466.84 Typical High $33,113.11 | Professional | None | $3,981.07 | $4,466.84 | $33,113.11 |
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 $3,715.35 Median $4,786.30 Typical High $6,165.95 | Professional | None | $3,715.35 | $4,786.30 | $6,165.95 |
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 $2,041.74 Median $2,089.30 Typical High $2,570.40 | Professional | 52 · Reduced service | $2,041.74 | $2,089.30 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $831.76 Typical High $1,047.13 | Professional | 53 · Discontinued | $812.83 | $831.76 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $3,162.28 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,090.30 | $3,162.28 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $630.96 Typical High $776.25 | Professional | 55 · Aftercare only | $616.60 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $416.87 Typical High $524.81 | Professional | 56 · Pre-op care only | $407.38 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $2,951.21 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $2,884.03 | $2,951.21 | $3,630.78 |
Where Kentucky sits
The same service costs 21.9 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· 48th of 51
$3,311
AK $14,125TX $646
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.