How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $11,220Professionalmedian $1,585 · 10th to 90th $1,230 to $2,455
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 $1,479.11 Median $1,737.80 Typical High $1,819.70 | Facility | None | $1,479.11 | $1,737.80 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,709.64 Typical High $14,125.38 | Facility | None | $5,128.61 | $8,709.64 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,584.89 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,398.83 Typical High $3,235.94 | Professional | 50 · Both sides | $1,819.70 | $2,398.83 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,000.00 Typical High $1,348.96 | Professional | 62 · Two surgeons | $776.25 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $251.19 Typical High $346.74 | Professional | 80 · Assistant surgeon | $194.98 | $251.19 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $223.87 Typical High $302.00 | Professional | AS · PA/NP assist | $169.82 | $223.87 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,137.96 | Facility | None | $1,148.15 | $1,380.38 | $2,137.96 |
CareSource Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,479.11 | $1,905.46 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,290.87 | Facility | None | $34.67 | $512.86 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $2,089.30 Typical High $9,120.11 | Professional | None | $1,380.38 | $2,089.30 | $9,120.11 |
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 $1,348.96 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,949.84 | $2,630.27 |
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 $707.95 Median $741.31 Typical High $954.99 | Professional | 52 · Reduced service | $707.95 | $741.31 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $380.19 | Professional | 53 · Discontinued | $288.40 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,122.02 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,071.52 | $1,122.02 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $288.40 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $147.91 Typical High $190.55 | Professional | 56 · Pre-op care only | $141.25 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,047.13 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,047.13 | $1,348.96 |
Where Kentucky sits
The same service costs 5.9 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· 39th of 51
$1,585
AK $5,888UT $1,000
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.