How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $9,772Professionalmedian $1,259 · 10th to 90th $977 to $1,862
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 $1,318.26 Median $1,348.96 Typical High $1,659.59 | Facility | None | $1,318.26 | $1,348.96 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,348.96 | $1,659.59 |
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 $954.99 Median $1,148.15 Typical High $1,445.44 | Professional | None | $954.99 | $1,148.15 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $724.44 Typical High $912.01 | Professional | 62 · Two surgeons | $602.56 | $724.44 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $186.21 Typical High $234.42 | Professional | 80 · Assistant surgeon | $154.88 | $186.21 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $162.18 Typical High $204.17 | Professional | AS · PA/NP assist | $134.90 | $162.18 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,995.26 | Facility | None | $1,071.52 | $1,288.25 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,584.89 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,238.72 | Facility | None | $34.67 | $691.83 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $7,079.46 | Professional | None | $1,288.25 | $1,445.44 | $7,079.46 |
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 $1,202.26 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,621.81 | $2,041.74 |
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 $660.69 Median $676.08 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $269.15 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,258.93 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $251.19 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $134.90 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $1,174.90 |
Where Kentucky sits
The same service costs 5.4 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
$1,259
AK $4,677TX $871
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.