How much rates vary
Facilitymedian $1,698 · 10th to 90th $776 to $4,266Professionalmedian $912 · 10th to 90th $776 to $1,413
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 $794.33 Median $1,071.52 Typical High $5,248.07 | Facility | None | $794.33 | $1,071.52 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,096.48 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,000.00 | Professional | None | $741.31 | $870.96 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $549.54 Typical High $776.25 | Professional | 62 · Two surgeons | $467.74 | $549.54 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $141.25 Typical High $158.49 | Professional | 80 · Assistant surgeon | $120.23 | $141.25 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $123.03 Typical High $141.25 | Professional | AS · PA/NP assist | $104.71 | $123.03 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,621.81 Typical High $2,344.23 | Facility | None | $870.96 | $1,621.81 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,621.81 | Professional | None | $933.25 | $1,230.27 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $1,819.70 | Facility | None | $1,230.27 | $1,659.59 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $5,128.61 | Professional | None | $1,047.13 | $1,174.90 | $5,128.61 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,659.59 | Professional | None | $954.99 | $1,318.26 | $1,659.59 |
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 $537.03 Median $537.03 Typical High $676.08 | Professional | 52 · Reduced service | $537.03 | $537.03 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $269.15 | Professional | 53 · Discontinued | $213.80 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $1,023.29 | Professional | 54 · Surgery only | $794.33 | $812.83 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $204.17 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $134.90 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $954.99 |
Where Kentucky sits
The same service costs 5.2 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
$912
AK $3,981TX $759
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.