How much rates vary
Facilitymedian $1,862 · 10th to 90th $813 to $11,482Professionalmedian $851 · 10th to 90th $661 to $1,349
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 $912.01 Typical High $5,248.07 | Facility | None | $794.33 | $912.01 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,071.52 | Professional | None | $776.25 | $812.83 | $1,071.52 |
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 $660.69 Median $851.14 Typical High $1,122.02 | Professional | None | $660.69 | $851.14 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $537.03 Typical High $691.83 | Professional | 62 · Two surgeons | $416.87 | $537.03 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $138.04 Typical High $177.83 | Professional | 80 · Assistant surgeon | $107.15 | $138.04 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $120.23 Typical High $154.88 | Professional | AS · PA/NP assist | $93.33 | $120.23 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $28,183.83 | Facility | None | $724.44 | $1,174.90 | $28,183.83 |
CareSource Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,202.26 | Professional | None | $741.31 | $1,000.00 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $20,892.96 | Facility | None | $1,258.93 | $1,659.59 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $4,786.30 | Professional | None | $758.58 | $1,122.02 | $4,786.30 |
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 $1,148.15 Median $3,162.28 Typical High $12,022.64 | Facility | None | $1,148.15 | $3,162.28 | $12,022.64 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,445.44 | Professional | None | $724.44 | $1,047.13 | $1,445.44 |
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 $389.05 Median $407.38 Typical High $524.81 | Professional | 52 · Reduced service | $389.05 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $208.93 | Professional | 53 · Discontinued | $154.88 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $776.25 | Professional | 54 · Surgery only | $588.84 | $616.60 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $154.88 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $104.71 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $724.44 |
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· 41st of 51
$912
AK $3,715TX $550
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.