How much rates vary
Facilitymedian $1,820 · 10th to 90th $457 to $9,550Professionalmedian $1,259 · 10th to 90th $977 to $1,950
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 $1,174.90 Median $1,380.38 Typical High $1,445.44 | Facility | None | $1,174.90 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,174.90 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $5,888.44 Typical High $11,220.18 | Facility | None | $3,467.37 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,698.24 | Professional | None | $977.24 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $794.33 Typical High $1,202.26 | Professional | 62 · Two surgeons | $616.60 | $794.33 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $199.53 Typical High $275.42 | Professional | 80 · Assistant surgeon | $158.49 | $199.53 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $173.78 Typical High $239.88 | Professional | AS · PA/NP assist | $138.04 | $173.78 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,698.24 | Facility | None | $912.01 | $1,096.48 | $1,698.24 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,479.11 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,819.70 | Facility | None | $34.67 | $691.83 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $7,079.46 | Professional | None | $1,096.48 | $1,698.24 | $7,079.46 |
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 $1,513.56 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,513.56 | $2,089.30 |
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 $562.34 Median $588.84 Typical High $758.58 | Professional | 52 · Reduced service | $562.34 | $588.84 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $302.00 | Professional | 53 · Discontinued | $223.87 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $1,122.02 | Professional | 54 · Surgery only | $851.14 | $891.25 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $229.09 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $151.36 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $1,047.13 |
Where Kentucky sits
The same service costs 5.8 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· 39th of 51
$1,259
AK $4,677TX $813
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.