How much rates vary
Facilitymedian $1,660 · 10th to 90th $646 to $4,266Professionalmedian $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 $5,248.07 | Facility | None | $645.65 | $758.58 | $5,248.07 |
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 $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 $524.81 Median $691.83 Typical High $912.01 | Professional | None | $524.81 | $691.83 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $436.52 Typical High $630.96 | Professional | 62 · Two surgeons | $331.13 | $436.52 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $109.65 Typical High $147.91 | Professional | 80 · Assistant surgeon | $83.18 | $109.65 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $95.50 Typical High $128.82 | Professional | AS · PA/NP assist | $74.13 | $95.50 | $128.82 |
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 $588.84 Median $812.83 Typical High $977.24 | Professional | None | $588.84 | $812.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $3,235.94 | Facility | None | $1,023.29 | $1,659.59 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $3,981.07 | Professional | None | $602.56 | $891.25 | $3,981.07 |
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 $123.03 Median $128.82 Typical High $165.96 | Professional | 53 · Discontinued | $123.03 | $128.82 | $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 4.4 times more in Alabama than in Montana. 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.
Physician feeFacility fee
AL $8,633MT $1,977
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.