How much rates vary
Facilitymedian $2,754 · 10th to 90th $759 to $10,715Professionalmedian $603 · 10th to 90th $479 to $871
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 $602.56 Median $758.58 Typical High $8,511.38 | Facility | None | $602.56 | $758.58 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $758.58 | Professional | None | $602.56 | $616.60 | $758.58 |
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 $457.09 Median $575.44 Typical High $851.14 | Professional | None | $457.09 | $575.44 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $870.96 Typical High $1,258.93 | Professional | 50 · Both sides | $676.08 | $870.96 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $363.08 Typical High $537.03 | Professional | 62 · Two surgeons | $281.84 | $363.08 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $91.20 Typical High $134.90 | Professional | 80 · Assistant surgeon | $72.44 | $91.20 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $81.28 Typical High $117.49 | Professional | AS · PA/NP assist | $63.10 | $81.28 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $2,818.38 | Facility | None | $549.54 | $912.01 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $912.01 | Professional | None | $512.86 | $707.95 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,995.26 Typical High $2,290.87 | Facility | None | $1,047.13 | $1,995.26 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $3,548.13 | Professional | None | $588.84 | $676.08 | $3,548.13 |
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 $549.54 Median $724.44 Typical High $933.25 | Professional | None | $549.54 | $724.44 | $933.25 |
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 $302.00 Median $309.03 Typical High $380.19 | Professional | 52 · Reduced service | $302.00 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $123.03 Typical High $151.36 | Professional | 53 · Discontinued | $120.23 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $457.09 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $426.58 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $416.87 | $426.58 | $537.03 |
Where Kentucky sits
The same service costs 5.9 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
$617
AK $2,512TX $427
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.