How much rates vary
Facilitymedian $1,445 · 10th to 90th $457 to $11,220Professionalmedian $955 · 10th to 90th $759 to $1,479
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 $933.25 Median $1,071.52 Typical High $1,122.02 | Facility | None | $933.25 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,174.90 | Professional | None | $891.25 | $933.25 | $1,174.90 |
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 $758.58 Median $954.99 Typical High $1,288.25 | Professional | None | $758.58 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $602.56 Typical High $812.83 | Professional | 62 · Two surgeons | $467.74 | $602.56 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $154.88 Typical High $204.17 | Professional | 80 · Assistant surgeon | $120.23 | $154.88 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $134.90 Typical High $181.97 | Professional | AS · PA/NP assist | $104.71 | $134.90 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $851.14 Typical High $1,318.26 | Facility | None | $707.95 | $851.14 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,380.38 | Professional | None | $912.01 | $1,174.90 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,445.44 | Facility | None | $34.67 | $512.86 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $5,495.41 | Professional | None | $851.14 | $1,318.26 | $5,495.41 |
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 $812.83 Median $1,202.26 Typical High $1,621.81 | Professional | None | $812.83 | $1,202.26 | $1,621.81 |
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 $436.52 Median $457.09 Typical High $588.84 | Professional | 52 · Reduced service | $436.52 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $234.42 | Professional | 53 · Discontinued | $177.83 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $691.83 Typical High $891.25 | Professional | 54 · Surgery only | $660.69 | $691.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $177.83 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $645.65 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $616.60 | $645.65 | $831.76 |
Where Kentucky sits
The same service costs 5.8 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· 41st of 51
$977
AK $3,631UT $631
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.