How much rates vary
Facilitymedian $1,023 · 10th to 90th $603 to $6,761Professionalmedian $617 · 10th to 90th $501 to $977
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 $602.56 Median $691.83 Typical High $794.33 | Facility | None | $602.56 | $691.83 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $776.25 | Professional | None | $575.44 | $602.56 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $870.96 | Professional | None | $478.63 | $616.60 | $870.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $389.05 Typical High $549.54 | Professional | 62 · Two surgeons | $302.00 | $389.05 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $100.00 Typical High $141.25 | Professional | 80 · Assistant surgeon | $77.62 | $100.00 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $87.10 Typical High $123.03 | Professional | AS · PA/NP assist | $67.61 | $87.10 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $870.96 | Facility | None | $457.09 | $549.54 | $870.96 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $891.25 | Professional | None | $537.03 | $758.58 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $933.25 Typical High $1,202.26 | Facility | None | $34.67 | $933.25 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $3,630.78 | Professional | None | $549.54 | $831.76 | $3,630.78 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,047.13 | Professional | None | $524.81 | $758.58 | $1,047.13 |
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 $288.40 Median $302.00 Typical High $380.19 | Professional | 52 · Reduced service | $288.40 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $120.23 Typical High $154.88 | Professional | 53 · Discontinued | $114.82 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $575.44 | Professional | 54 · Surgery only | $426.58 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $89.13 Typical High $114.82 | Professional | 55 · Aftercare only | $85.11 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $60.26 Typical High $77.62 | Professional | 56 · Pre-op care only | $57.54 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $537.03 |
Where Kentucky sits
The same service costs 5.2 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· 46th of 51
$661
AK $2,344UT $447
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.