How much rates vary
Facilitymedian $2,089 · 10th to 90th $977 to $11,220Professionalmedian $1,148 · 10th to 90th $891 to $1,698
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 $851.14 Median $1,230.27 Typical High $8,511.38 | Facility | None | $851.14 | $1,230.27 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,258.93 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $10,471.29 Typical High $13,182.57 | Facility | None | $4,786.30 | $10,471.29 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,288.25 | Professional | None | $870.96 | $1,047.13 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $660.69 Typical High $812.83 | Professional | 62 · Two surgeons | $549.54 | $660.69 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $165.96 Typical High $208.93 | Professional | 80 · Assistant surgeon | $141.25 | $165.96 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $181.97 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,862.09 | Facility | None | $1,000.00 | $1,202.26 | $1,862.09 |
CareSource Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,412.54 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,089.30 Typical High $6,165.95 | Facility | None | $34.67 | $2,089.30 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $5,754.40 | Professional | None | $1,202.26 | $1,380.38 | $5,754.40 |
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 $1,148.15 Median $3,162.28 Typical High $12,302.69 | Facility | None | $1,148.15 | $3,162.28 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,548.82 | $1,949.84 |
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 $602.56 Median $630.96 Typical High $776.25 | Professional | 52 · Reduced service | $602.56 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $309.03 | Professional | 53 · Discontinued | $239.88 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $933.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $912.01 | $933.25 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $186.21 Typical High $234.42 | Professional | 55 · Aftercare only | $181.97 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $154.88 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $870.96 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $851.14 | $870.96 | $1,096.48 |
Where Kentucky sits
The same service costs 25.7 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
$1,148
AK $5,129TX $200
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.