How much rates vary
Facilitymedian $1,950 · 10th to 90th $457 to $9,550Professionalmedian $1,318 · 10th to 90th $1,023 to $2,042
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 $1,258.93 Median $1,445.44 Typical High $1,548.82 | Facility | None | $1,258.93 | $1,445.44 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,258.93 | $1,621.81 |
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 $1,023.29 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,318.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,949.84 Typical High $2,754.23 | Professional | 50 · Both sides | $1,548.82 | $1,949.84 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $831.76 Typical High $1,174.90 | Professional | 62 · Two surgeons | $645.65 | $831.76 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $295.12 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $181.97 Typical High $257.04 | Professional | AS · PA/NP assist | $144.54 | $181.97 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,819.70 | Facility | None | $954.99 | $1,148.15 | $1,819.70 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,513.56 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,949.84 | Facility | None | $34.67 | $691.83 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $7,585.78 | Professional | None | $1,148.15 | $1,778.28 | $7,585.78 |
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 $1,096.48 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,621.81 | $2,238.72 |
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 $602.56 Median $630.96 Typical High $812.83 | Professional | 52 · Reduced service | $602.56 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $323.59 | Professional | 53 · Discontinued | $239.88 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $933.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $891.25 | $933.25 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $239.88 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $162.18 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $870.96 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $831.76 | $870.96 | $1,122.02 |
Where Kentucky sits
The same service costs 5.9 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· 40th of 51
$1,318
AK $4,898TX $832
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.