How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $11,220Professionalmedian $1,738 · 10th to 90th $1,380 to $2,754
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 $1,548.82 Median $1,548.82 Typical High $1,905.46 | Facility | None | $1,548.82 | $1,548.82 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,548.82 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,709.64 Typical High $14,125.38 | Facility | None | $5,128.61 | $8,709.64 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,737.80 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,096.48 Typical High $1,479.11 | Professional | 62 · Two surgeons | $870.96 | $1,096.48 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $275.42 Typical High $371.54 | Professional | 80 · Assistant surgeon | $218.78 | $275.42 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $245.47 Typical High $331.13 | Professional | AS · PA/NP assist | $194.98 | $245.47 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,398.83 | Facility | None | $1,258.93 | $1,513.56 | $2,398.83 |
CareSource Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,621.81 | $2,089.30 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,570.40 | Facility | None | $34.67 | $512.86 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $9,772.37 | Professional | None | $1,513.56 | $2,344.23 | $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 $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,548.82 | $2,137.96 | $2,884.03 |
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 $776.25 Median $776.25 Typical High $954.99 | Professional | 52 · Reduced service | $776.25 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $380.19 | Professional | 53 · Discontinued | $309.03 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $281.84 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $190.55 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,318.26 |
Where Kentucky sits
The same service costs 5.9 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· 38th of 51
$1,738
AK $6,457TX $1,096
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.