How much rates vary
Facilitymedian $2,951 · 10th to 90th $380 to $8,511Professionalmedian $4,074 · 10th to 90th $3,311 to $5,754
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 $4,168.69 Median $4,677.35 Typical High $5,248.07 | Facility | None | $4,168.69 | $4,677.35 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $4,168.69 Median $4,265.80 Typical High $5,248.07 | Professional | None | $4,168.69 | $4,265.80 | $5,248.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,311.31 Median $3,981.07 Typical High $5,248.07 | Professional | None | $3,311.31 | $3,981.07 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,089.30 Median $2,511.89 Typical High $3,311.31 | Professional | 62 · Two surgeons | $2,089.30 | $2,511.89 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $645.65 Typical High $851.14 | Professional | 80 · Assistant surgeon | $524.81 | $645.65 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $562.34 Typical High $741.31 | Professional | AS · PA/NP assist | $467.74 | $562.34 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $3,388.44 Median $4,073.80 Typical High $6,309.57 | Facility | None | $3,388.44 | $4,073.80 | $6,309.57 |
CareSource Setting Professional Modifier None Typical Low $3,630.78 Median $4,897.79 Typical High $6,309.57 | Professional | None | $3,630.78 | $4,897.79 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $7,079.46 | Facility | None | $34.67 | $512.86 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $4,466.84 Typical High $22,908.68 | Professional | None | $4,073.80 | $4,466.84 | $22,908.68 |
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 $3,801.89 Median $5,011.87 Typical High $6,309.57 | Professional | None | $3,801.89 | $5,011.87 | $6,309.57 |
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 $2,089.30 Median $2,137.96 Typical High $2,630.27 | Professional | 52 · Reduced service | $2,089.30 | $2,137.96 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $851.14 Typical High $1,047.13 | Professional | 53 · Discontinued | $831.76 | $851.14 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $3,162.28 Typical High $3,981.07 | Professional | 54 · Surgery only | $3,090.30 | $3,162.28 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $630.96 Typical High $794.33 | Professional | 55 · Aftercare only | $616.60 | $630.96 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $426.58 Typical High $524.81 | Professional | 56 · Pre-op care only | $416.87 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $2,951.21 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,884.03 | $2,951.21 | $3,715.35 |
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· 44th of 51
$4,074
AK $14,125TX $676
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.