How much rates vary
Facilitymedian $1,862 · 10th to 90th $457 to $9,772Professionalmedian $1,122 · 10th to 90th $912 to $1,778
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 $1,096.48 Median $1,318.26 Typical High $1,412.54 | Facility | None | $1,096.48 | $1,318.26 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,122.02 | $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 $912.01 Median $1,122.02 Typical High $1,778.28 | Professional | None | $912.01 | $1,122.02 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $707.95 Typical High $1,122.02 | Professional | 62 · Two surgeons | $575.44 | $707.95 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $177.83 Typical High $288.40 | Professional | 80 · Assistant surgeon | $147.91 | $177.83 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $251.19 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,698.24 | Facility | None | $891.25 | $1,071.52 | $1,698.24 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,318.26 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,862.09 | Facility | None | $34.67 | $512.86 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $6,918.31 | Professional | None | $1,071.52 | $1,258.93 | $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 $1,047.13 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,412.54 | $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 $549.54 Median $562.34 Typical High $707.95 | Professional | 52 · Reduced service | $549.54 | $562.34 | $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 $831.76 Median $851.14 Typical High $1,047.13 | Professional | 54 · Surgery only | $831.76 | $851.14 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $208.93 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $977.24 |
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· 43rd of 51
$1,122
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.