How much rates vary
Facilitymedian $1,514 · 10th to 90th $457 to $11,220Professionalmedian $1,023 · 10th to 90th $813 to $1,585
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 $977.24 Median $1,122.02 Typical High $1,202.26 | Facility | None | $977.24 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,258.93 | Professional | None | $933.25 | $977.24 | $1,258.93 |
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 $812.83 Median $1,023.29 Typical High $1,380.38 | Professional | None | $812.83 | $1,023.29 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,548.82 Typical High $2,089.30 | Professional | 50 · Both sides | $1,202.26 | $1,548.82 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $645.65 Typical High $870.96 | Professional | 62 · Two surgeons | $501.19 | $645.65 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $165.96 Typical High $223.87 | Professional | 80 · Assistant surgeon | $128.82 | $165.96 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $144.54 Typical High $194.98 | Professional | AS · PA/NP assist | $112.20 | $144.54 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $891.25 Typical High $1,412.54 | Facility | None | $741.31 | $891.25 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Professional | None | $954.99 | $1,230.27 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,513.56 | Facility | None | $34.67 | $512.86 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $5,888.44 | Professional | None | $891.25 | $1,348.96 | $5,888.44 |
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 $870.96 Median $1,258.93 Typical High $1,737.80 | Professional | None | $870.96 | $1,258.93 | $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 $467.74 Median $489.78 Typical High $616.60 | Professional | 52 · Reduced service | $467.74 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $251.19 | Professional | 53 · Discontinued | $186.21 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $933.25 | Professional | 54 · Surgery only | $691.83 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $186.21 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $125.89 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $870.96 |
Where Kentucky sits
The same service costs 7.9 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· 41st of 51
$1,023
AK $3,802TX $479
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.