How much rates vary
Facilitymedian $1,862 · 10th to 90th $457 to $9,772Professionalmedian $1,072 · 10th to 90th $832 to $1,549
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 $1,122.02 Median $1,148.15 Typical High $1,412.54 | Facility | None | $1,122.02 | $1,148.15 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,148.15 | $1,412.54 |
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 $812.83 Median $977.24 Typical High $1,230.27 | Professional | None | $812.83 | $977.24 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $616.60 Typical High $776.25 | Professional | 62 · Two surgeons | $512.86 | $616.60 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $158.49 Typical High $194.98 | Professional | 80 · Assistant surgeon | $128.82 | $158.49 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $138.04 Typical High $173.78 | Professional | AS · PA/NP assist | $112.20 | $138.04 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,698.24 | Facility | None | $912.01 | $1,096.48 | $1,698.24 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,348.96 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,905.46 | Facility | None | $34.67 | $691.83 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $5,888.44 | Professional | None | $1,096.48 | $1,230.27 | $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 $1,023.29 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,380.38 | $1,737.80 |
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 $562.34 Median $575.44 Typical High $707.95 | Professional | 52 · Reduced service | $562.34 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $281.84 | Professional | 53 · Discontinued | $223.87 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $870.96 Typical High $1,071.52 | Professional | 54 · Surgery only | $851.14 | $870.96 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $173.78 Typical High $213.80 | Professional | 55 · Aftercare only | $169.82 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $141.25 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $812.83 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $794.33 | $812.83 | $1,000.00 |
Where Kentucky sits
The same service costs 5.6 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· 46th of 51
$1,072
AK $4,266TX $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.