How much rates vary
Facilitymedian $2,754 · 10th to 90th $631 to $10,715Professionalmedian $398 · 10th to 90th $316 to $562
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 $398.11 Median $501.19 Typical High $8,511.38 | Facility | None | $398.11 | $501.19 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $501.19 | Professional | None | $398.11 | $407.38 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $4,073.80 Typical High $12,022.64 | Facility | None | $1,445.44 | $4,073.80 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $549.54 | Professional | None | $316.23 | $389.05 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $575.44 Typical High $831.76 | Professional | 50 · Both sides | $467.74 | $575.44 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $245.47 Typical High $346.74 | Professional | 62 · Two surgeons | $199.53 | $245.47 | $346.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $61.66 Typical High $89.13 | Professional | 80 · Assistant surgeon | $50.12 | $61.66 | $89.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $53.70 Typical High $77.62 | Professional | AS · PA/NP assist | $43.65 | $53.70 | $77.62 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $602.56 Typical High $2,818.38 | Facility | None | $363.08 | $602.56 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $602.56 | Professional | None | $371.54 | $478.63 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,995.26 Typical High $2,290.87 | Facility | None | $691.83 | $1,995.26 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $3,467.37 | Professional | None | $389.05 | $446.68 | $3,467.37 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $616.60 | Professional | None | $363.08 | $489.78 | $616.60 |
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 $199.53 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $199.53 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $102.33 | Professional | 53 · Discontinued | $79.43 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $302.00 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $60.26 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $50.12 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $288.40 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $281.84 | $288.40 | $354.81 |
Where Kentucky sits
The same service costs 5.6 times more in Alaska than in Utah. 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
$407
AK $1,660UT $295
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.