How much rates vary
Facilitymedian $1,778 · 10th to 90th $794 to $4,266Professionalmedian $1,230 · 10th to 90th $977 to $1,950
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 $1,288.25 Typical High $5,248.07 | Facility | None | $794.33 | $1,288.25 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,174.90 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,621.81 | Professional | None | $977.24 | $1,230.27 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $776.25 Typical High $1,023.29 | Professional | 62 · Two surgeons | $602.56 | $776.25 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $194.98 Typical High $257.04 | Professional | 80 · Assistant surgeon | $154.88 | $194.98 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $173.78 Typical High $223.87 | Professional | AS · PA/NP assist | $134.90 | $173.78 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $4,265.80 | Facility | None | $1,047.13 | $1,698.24 | $4,265.80 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,479.11 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $1,288.25 | $1,819.70 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $6,606.93 | Professional | None | $1,096.48 | $1,698.24 | $6,606.93 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,513.56 | $2,089.30 |
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 $562.34 Median $588.84 Typical High $758.58 | Professional | 52 · Reduced service | $562.34 | $588.84 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $302.00 | Professional | 53 · Discontinued | $223.87 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $1,122.02 | Professional | 54 · Surgery only | $851.14 | $891.25 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $229.09 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $151.36 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $1,047.13 |
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
$1,288
AK $4,677UT $813
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.