How much rates vary
Facilitymedian $2,455 · 10th to 90th $933 to $8,318Professionalmedian $1,549 · 10th to 90th $1,175 to $2,399
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 $1,348.96 Typical High $2,630.27 | Facility | None | $794.33 | $1,348.96 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,348.96 | $1,862.09 |
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 $1,174.90 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,548.82 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $977.24 Typical High $1,412.54 | Professional | 62 · Two surgeons | $741.31 | $977.24 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $251.19 Typical High $354.81 | Professional | 80 · Assistant surgeon | $190.55 | $251.19 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $218.78 Typical High $309.03 | Professional | AS · PA/NP assist | $165.96 | $218.78 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,288.25 | $2,089.30 | $4,265.80 |
CareSource Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,819.70 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $3,311.31 | Facility | None | $1,819.70 | $2,238.72 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $9,772.37 | Professional | None | $1,348.96 | $2,089.30 | $9,772.37 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,412.54 | $2,041.74 | $2,570.40 |
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 $676.08 Median $676.08 Typical High $912.01 | Professional | 52 · Reduced service | $676.08 | $676.08 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $371.54 | Professional | 53 · Discontinued | $269.15 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $186.21 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,288.25 |
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· 44th of 51
$1,585
AK $5,623UT $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.