How much rates vary
Facilitymedian $1,148 · 10th to 90th $646 to $8,913Professionalmedian $759 · 10th to 90th $603 to $1,202
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 $741.31 Median $851.14 Typical High $891.25 | Facility | None | $741.31 | $851.14 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $933.25 | Professional | None | $707.95 | $741.31 | $933.25 |
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 $588.84 Median $758.58 Typical High $1,023.29 | Professional | None | $588.84 | $758.58 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $478.63 Typical High $645.65 | Professional | 62 · Two surgeons | $371.54 | $478.63 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $123.03 Typical High $162.18 | Professional | 80 · Assistant surgeon | $95.50 | $123.03 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $107.15 Typical High $144.54 | Professional | AS · PA/NP assist | $83.18 | $107.15 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $1,047.13 | Facility | None | $562.34 | $676.08 | $1,047.13 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,096.48 | Professional | None | $660.69 | $933.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,148.15 | Facility | None | $34.67 | $691.83 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,023.29 Typical High $4,466.84 | Professional | None | $676.08 | $1,023.29 | $4,466.84 |
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 $645.65 Median $933.25 Typical High $1,288.25 | Professional | None | $645.65 | $933.25 | $1,288.25 |
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 $346.74 Median $363.08 Typical High $467.74 | Professional | 52 · Reduced service | $346.74 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $147.91 Typical High $186.21 | Professional | 53 · Discontinued | $141.25 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $549.54 Typical High $707.95 | Professional | 54 · Surgery only | $524.81 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $141.25 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $74.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $70.79 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $660.69 |
Where Kentucky sits
The same service costs 5.4 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· 45th of 51
$776
AK $2,884UT $537
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.