How much rates vary
Facilitymedian $2,344 · 10th to 90th $871 to $8,318Professionalmedian $1,096 · 10th to 90th $851 to $1,738
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 $977.24 Typical High $2,630.27 | Facility | None | $794.33 | $977.24 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Professional | None | $977.24 | $977.24 | $1,318.26 |
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 $851.14 Median $1,096.48 Typical High $1,621.81 | Professional | None | $851.14 | $1,096.48 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $691.83 Typical High $1,023.29 | Professional | 62 · Two surgeons | $537.03 | $691.83 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $177.83 Typical High $257.04 | Professional | 80 · Assistant surgeon | $134.90 | $177.83 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $154.88 Typical High $229.09 | Professional | AS · PA/NP assist | $117.49 | $154.88 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $4,265.80 | Facility | None | $912.01 | $1,479.11 | $4,265.80 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,318.26 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $3,311.31 | Facility | None | $1,621.81 | $1,862.09 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $6,918.31 | Professional | None | $954.99 | $1,479.11 | $6,918.31 |
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 $977.24 Median $1,445.44 Typical High $1,819.70 | Professional | None | $977.24 | $1,445.44 | $1,819.70 |
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 $489.78 Median $489.78 Typical High $660.69 | Professional | 52 · Reduced service | $489.78 | $489.78 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | 53 · Discontinued | $194.98 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $977.24 | Professional | 54 · Surgery only | $724.44 | $724.44 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $199.53 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $912.01 |
Where Kentucky sits
The same service costs 5.6 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· 46th of 51
$1,122
AK $4,074UT $724
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.