How much rates vary
Facilitymedian $1,122 · 10th to 90th $708 to $5,623Professionalmedian $851 · 10th to 90th $646 to $1,318
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 $794.33 Median $954.99 Typical High $977.24 | Facility | None | $794.33 | $954.99 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,023.29 | Professional | None | $758.58 | $794.33 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,122.02 | Professional | None | $645.65 | $851.14 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,288.25 Typical High $1,698.24 | Professional | 50 · Both sides | $977.24 | $1,288.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $537.03 Typical High $707.95 | Professional | 62 · Two surgeons | $407.38 | $537.03 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $134.90 Typical High $177.83 | Professional | 80 · Assistant surgeon | $104.71 | $134.90 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $120.23 Typical High $158.49 | Professional | AS · PA/NP assist | $91.20 | $120.23 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $1,148.15 Typical High $2,818.38 | Facility | None | $707.95 | $1,148.15 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,202.26 | Professional | None | $794.33 | $1,000.00 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,258.93 Typical High $2,041.74 | Facility | None | $34.67 | $1,258.93 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $4,897.79 | Professional | None | $741.31 | $1,148.15 | $4,897.79 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,412.54 | Professional | None | $724.44 | $1,023.29 | $1,412.54 |
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 $380.19 Median $398.11 Typical High $512.86 | Professional | 52 · Reduced service | $380.19 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $776.25 | Professional | 54 · Surgery only | $575.44 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $154.88 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $102.33 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $724.44 |
Where Kentucky sits
The same service costs 5.8 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· 43rd of 51
$851
AK $3,162UT $550
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.