How much rates vary
Facilitymedian $2,042 · 10th to 90th $708 to $7,586Professionalmedian $692 · 10th to 90th $525 to $1,047
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 $645.65 Median $758.58 Typical High $1,258.93 | Facility | None | $645.65 | $758.58 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $851.14 | Professional | None | $616.60 | $645.65 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $891.25 | Professional | None | $524.81 | $691.83 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $426.58 Typical High $630.96 | Professional | 62 · Two surgeons | $331.13 | $426.58 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $109.65 Typical High $141.25 | Professional | 80 · Assistant surgeon | $85.11 | $109.65 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $95.50 Typical High $123.03 | Professional | AS · PA/NP assist | $74.13 | $95.50 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $4,265.80 | Facility | None | $575.44 | $933.25 | $4,265.80 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $977.24 | Professional | None | $537.03 | $831.76 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,862.09 Typical High $3,311.31 | Facility | None | $707.95 | $1,862.09 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $912.01 Typical High $3,890.45 | Professional | None | $602.56 | $912.01 | $3,890.45 |
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 $575.44 Median $831.76 Typical High $1,148.15 | Professional | None | $575.44 | $831.76 | $1,148.15 |
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 $309.03 Median $323.59 Typical High $416.87 | Professional | 52 · Reduced service | $309.03 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $165.96 | Professional | 53 · Discontinued | $125.89 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $489.78 Typical High $630.96 | Professional | 54 · Surgery only | $467.74 | $489.78 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $97.72 Typical High $125.89 | Professional | 55 · Aftercare only | $93.33 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $83.18 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $457.09 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $436.52 | $457.09 | $588.84 |
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· 42nd of 51
$759
AK $2,570UT $479
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.