How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $9,772Professionalmedian $1,349 · 10th to 90th $1,072 to $2,042
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 $891.25 Median $1,445.44 Typical High $8,511.38 | Facility | None | $891.25 | $1,445.44 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,479.11 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $6,025.60 Typical High $11,220.18 | Facility | None | $3,548.13 | $6,025.60 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,288.25 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $812.83 Typical High $1,000.00 | Professional | 62 · Two surgeons | $660.69 | $812.83 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $257.04 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $177.83 Typical High $223.87 | Professional | AS · PA/NP assist | $147.91 | $177.83 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,187.76 | Facility | None | $1,174.90 | $1,412.54 | $2,187.76 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,737.80 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,454.71 | Facility | None | $34.67 | $512.86 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $6,918.31 | Professional | None | $1,412.54 | $1,621.81 | $6,918.31 |
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 $1,348.96 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,778.28 | $2,290.87 |
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 $707.95 Median $741.31 Typical High $912.01 | Professional | 52 · Reduced service | $707.95 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $295.12 Typical High $363.08 | Professional | 53 · Discontinued | $281.84 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,096.48 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,071.52 | $1,096.48 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $275.42 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $147.91 Typical High $181.97 | Professional | 56 · Pre-op care only | $141.25 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,023.29 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,023.29 | $1,288.25 |
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· 47th of 51
$1,349
AK $5,129TX $977
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.