How much rates vary
Facilitymedian $1,738 · 10th to 90th $468 to $13,183Professionalmedian $1,175 · 10th to 90th $977 to $1,820
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 $1,122.02 Median $1,318.26 Typical High $8,511.38 | Facility | None | $1,122.02 | $1,318.26 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,122.02 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,709.64 Typical High $14,125.38 | Facility | None | $5,128.61 | $8,709.64 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,548.82 | Professional | None | $977.24 | $1,174.90 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $741.31 Typical High $977.24 | Professional | 62 · Two surgeons | $616.60 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $190.55 Typical High $245.47 | Professional | 80 · Assistant surgeon | $154.88 | $190.55 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $165.96 Typical High $213.80 | Professional | AS · PA/NP assist | $134.90 | $165.96 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,621.81 | Facility | None | $851.14 | $1,023.29 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,412.54 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,737.80 | Facility | None | $34.67 | $512.86 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $10,232.93 | Professional | None | $1,023.29 | $1,621.81 | $10,232.93 |
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 $1,000.00 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,412.54 | $1,949.84 |
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 $537.03 Median $562.34 Typical High $707.95 | Professional | 52 · Reduced service | $537.03 | $562.34 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $281.84 | Professional | 53 · Discontinued | $213.80 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $1,071.52 | Professional | 54 · Surgery only | $794.33 | $831.76 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $213.80 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $1,000.00 |
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· 39th of 51
$1,175
AK $4,365TX $741
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.