How much rates vary
Facilitymedian $2,884 · 10th to 90th $794 to $11,749Professionalmedian $794 · 10th to 90th $617 to $1,259
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 $660.69 Median $851.14 Typical High $3,630.78 | Facility | None | $660.69 | $851.14 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,230.27 | Professional | None | $645.65 | $724.44 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,890.45 Typical High $13,803.84 | Facility | None | $1,202.26 | $3,890.45 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,148.15 | Professional | None | $588.84 | $776.25 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $489.78 Typical High $724.44 | Professional | 62 · Two surgeons | $371.54 | $489.78 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $123.03 Typical High $186.21 | Professional | 80 · Assistant surgeon | $93.33 | $123.03 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $107.15 Typical High $162.18 | Professional | AS · PA/NP assist | $83.18 | $107.15 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $4,897.79 | Facility | None | $676.08 | $954.99 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,096.48 | Professional | None | $676.08 | $758.58 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $3,548.13 | Facility | None | $1,174.90 | $2,290.87 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $4,786.30 | Professional | None | $707.95 | $1,023.29 | $4,786.30 |
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 $691.83 Median $1,047.13 Typical High $1,380.38 | Professional | None | $691.83 | $1,047.13 | $1,380.38 |
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 $323.59 Median $354.81 Typical High $436.52 | Professional | 52 · Reduced service | $323.59 | $354.81 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $173.78 | Professional | 53 · Discontinued | $131.83 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $645.65 | Professional | 54 · Surgery only | $489.78 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $128.82 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $70.79 Typical High $87.10 | Professional | 56 · Pre-op care only | $64.57 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $602.56 |
Where Kentucky sits
The same service costs 4.5 times more in Alaska 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
AK $10,099MT $2,245
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.