How much rates vary
Facilitymedian $2,042 · 10th to 90th $457 to $11,220Professionalmedian $1,738 · 10th to 90th $1,380 to $2,754
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 $1,698.24 Median $2,041.74 Typical High $2,041.74 | Facility | None | $1,698.24 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,621.81 | $1,698.24 | $2,137.96 |
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 $1,380.38 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,737.80 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,096.48 Typical High $1,548.82 | Professional | 62 · Two surgeons | $870.96 | $1,096.48 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $281.84 Typical High $389.05 | Professional | 80 · Assistant surgeon | $223.87 | $281.84 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $245.47 Typical High $338.84 | Professional | AS · PA/NP assist | $194.98 | $245.47 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,398.83 | Facility | None | $1,288.25 | $1,548.82 | $2,398.83 |
CareSource Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,380.38 | $2,137.96 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,570.40 | Facility | None | $34.67 | $691.83 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,398.83 Typical High $15,848.93 | Professional | None | $1,548.82 | $2,398.83 | $15,848.93 |
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 $1,479.11 Median $2,137.96 Typical High $2,951.21 | Professional | None | $1,479.11 | $2,137.96 | $2,951.21 |
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 $794.33 Median $831.76 Typical High $1,071.52 | Professional | 52 · Reduced service | $794.33 | $831.76 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $338.84 Typical High $426.58 | Professional | 53 · Discontinued | $323.59 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,258.93 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,202.26 | $1,258.93 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $251.19 Typical High $323.59 | Professional | 55 · Aftercare only | $239.88 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $169.82 Typical High $213.80 | Professional | 56 · Pre-op care only | $162.18 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,174.90 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,174.90 | $1,513.56 |
Where Kentucky sits
The same service costs 6.8 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· 37th of 51
$1,778
AK $6,607TX $977
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.