How much rates vary
Facilitymedian $1,778 · 10th to 90th $457 to $9,772Professionalmedian $1,023 · 10th to 90th $832 to $1,479
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 $1,023.29 Median $1,122.02 Typical High $1,288.25 | Facility | None | $1,023.29 | $1,122.02 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,047.13 | $1,288.25 |
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 $831.76 Median $1,000.00 Typical High $1,348.96 | Professional | None | $831.76 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $630.96 Typical High $851.14 | Professional | 62 · Two surgeons | $524.81 | $630.96 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $162.18 Typical High $218.78 | Professional | 80 · Assistant surgeon | $131.83 | $162.18 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $141.25 Typical High $190.55 | Professional | AS · PA/NP assist | $117.49 | $141.25 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,548.82 | Facility | None | $831.76 | $1,000.00 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,548.82 | Professional | None | $870.96 | $1,230.27 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,778.28 | Facility | None | $34.67 | $512.86 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $5,888.44 | Professional | None | $1,000.00 | $1,122.02 | $5,888.44 |
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 $954.99 Median $1,288.25 Typical High $1,621.81 | Professional | None | $954.99 | $1,288.25 | $1,621.81 |
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 $512.86 Median $524.81 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $524.81 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $263.03 | Professional | 53 · Discontinued | $204.17 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $977.24 | Professional | 54 · Surgery only | $776.25 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $194.98 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $104.71 Typical High $128.82 | Professional | 56 · Pre-op care only | $102.33 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $912.01 |
Where Kentucky sits
The same service costs 24.5 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· 43rd of 51
$1,023
AK $4,266TX $174
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.