How much rates vary
Facilitymedian $1,413 · 10th to 90th $457 to $9,550Professionalmedian $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 $912.01 Median $1,023.29 Typical High $1,122.02 | Facility | None | $912.01 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,148.15 | Professional | None | $870.96 | $912.01 | $1,148.15 |
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 $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 $478.63 Median $602.56 Typical High $812.83 | Professional | 62 · Two surgeons | $478.63 | $602.56 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $151.36 Typical High $204.17 | Professional | 80 · Assistant surgeon | $123.03 | $151.36 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $131.83 Typical High $177.83 | Professional | AS · PA/NP assist | $107.15 | $131.83 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $831.76 Typical High $1,318.26 | Facility | None | $691.83 | $831.76 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,348.96 | Professional | None | $812.83 | $1,148.15 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,412.54 | Facility | None | $34.67 | $691.83 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,288.25 Typical High $5,370.32 | Professional | None | $831.76 | $1,288.25 | $5,370.32 |
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 $794.33 Median $1,148.15 Typical High $1,584.89 | Professional | None | $794.33 | $1,148.15 | $1,584.89 |
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 $436.52 Median $457.09 Typical High $575.44 | Professional | 52 · Reduced service | $436.52 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $181.97 Typical High $234.42 | Professional | 53 · Discontinued | $173.78 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $676.08 Typical High $870.96 | Professional | 54 · Surgery only | $645.65 | $676.08 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $173.78 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $630.96 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $602.56 | $630.96 | $812.83 |
Where Kentucky sits
The same service costs 5.6 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
$955
AK $3,548TX $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.