How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $9,772Professionalmedian $1,259 · 10th to 90th $1,023 to $1,820
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 $1,258.93 Median $1,348.96 Typical High $1,621.81 | Facility | None | $1,258.93 | $1,348.96 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,288.25 | $1,621.81 |
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 $1,023.29 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,230.27 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $776.25 Typical High $977.24 | Professional | 62 · Two surgeons | $645.65 | $776.25 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $199.53 Typical High $251.19 | Professional | 80 · Assistant surgeon | $165.96 | $199.53 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $173.78 Typical High $218.78 | Professional | AS · PA/NP assist | $144.54 | $173.78 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,949.84 | Facility | None | $1,023.29 | $1,230.27 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,513.56 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,137.96 | Facility | None | $34.67 | $691.83 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $6,918.31 | Professional | None | $1,230.27 | $1,412.54 | $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 $1,174.90 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,584.89 | $1,995.26 |
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 $630.96 Median $645.65 Typical High $812.83 | Professional | 52 · Reduced service | $630.96 | $645.65 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $263.03 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $1,202.26 | Professional | 54 · Surgery only | $954.99 | $977.24 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $239.88 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $162.18 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $1,122.02 |
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· 45th of 51
$1,259
AK $4,571TX $851
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.