How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $9,550Professionalmedian $1,380 · 10th to 90th $1,122 to $2,188
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 $1,445.44 Median $1,479.11 Typical High $1,778.28 | Facility | None | $1,445.44 | $1,479.11 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,445.44 | $1,819.70 |
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 $1,122.02 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,348.96 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $851.14 Typical High $1,258.93 | Professional | 62 · Two surgeons | $707.95 | $851.14 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $213.80 Typical High $295.12 | Professional | 80 · Assistant surgeon | $177.83 | $213.80 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $190.55 Typical High $263.03 | Professional | AS · PA/NP assist | $154.88 | $190.55 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,089.30 | Facility | None | $1,096.48 | $1,318.26 | $2,089.30 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,819.70 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,344.23 | Facility | None | $34.67 | $691.83 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $7,762.47 | Professional | None | $1,348.96 | $1,862.09 | $7,762.47 |
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 $1,174.90 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,698.24 | $2,511.89 |
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 $691.83 Median $724.44 Typical High $912.01 | Professional | 52 · Reduced service | $691.83 | $724.44 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $288.40 Typical High $363.08 | Professional | 53 · Discontinued | $275.42 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $144.54 Typical High $181.97 | Professional | 56 · Pre-op care only | $138.04 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,258.93 |
Where Kentucky sits
The same service costs 21.4 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
$1,413
AK $5,754TX $269
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.