How much rates vary
Facilitymedian $1,023 · 10th to 90th $407 to $3,981Professionalmedian $457 · 10th to 90th $347 to $708
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 $407.38 Median $407.38 Typical High $3,801.89 | Facility | None | $407.38 | $407.38 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | None | $407.38 | $407.38 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $588.84 | Professional | None | $346.74 | $457.09 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $676.08 Typical High $870.96 | Professional | 50 · Both sides | $524.81 | $676.08 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $72.44 Typical High $93.33 | Professional | 80 · Assistant surgeon | $56.23 | $72.44 | $93.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $63.10 Typical High $81.28 | Professional | AS · PA/NP assist | $48.98 | $63.10 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $630.96 Typical High $1,621.81 | Facility | None | $380.19 | $630.96 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $645.65 | Professional | None | $354.81 | $524.81 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,202.26 | Facility | None | $34.67 | $691.83 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $2,570.40 | Professional | None | $398.11 | $602.56 | $2,570.40 |
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 $407.38 Median $549.54 Typical High $758.58 | Professional | None | $407.38 | $549.54 | $758.58 |
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 $204.17 Median $204.17 Typical High $245.47 | Professional | 52 · Reduced service | $204.17 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $338.84 |
Where Kentucky sits
The same service costs 5.1 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· 47th of 51
$468
AK $1,698UT $331
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.