How much rates vary
Facilitymedian $1,479 · 10th to 90th $501 to $9,333Professionalmedian $562 · 10th to 90th $437 to $891
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 $501.19 Median $562.34 Typical High $8,511.38 | Facility | None | $501.19 | $562.34 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $602.56 | Professional | None | $489.78 | $537.03 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $13,489.63 | Facility | None | $5,011.87 | $8,317.64 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $758.58 | Professional | None | $436.52 | $562.34 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $354.81 Typical High $549.54 | Professional | 62 · Two surgeons | $275.42 | $354.81 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $89.13 Typical High $117.49 | Professional | 80 · Assistant surgeon | $69.18 | $89.13 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $77.62 Typical High $104.71 | Professional | AS · PA/NP assist | $60.26 | $77.62 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $1,778.28 | Facility | None | $501.19 | $1,000.00 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $851.14 | Professional | None | $467.74 | $724.44 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $891.25 | Facility | None | $34.67 | $512.86 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $3,162.28 | Professional | None | $524.81 | $741.31 | $3,162.28 |
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 $489.78 Median $741.31 Typical High $1,023.29 | Professional | None | $489.78 | $741.31 | $1,023.29 |
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 $245.47 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $245.47 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $97.72 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $457.09 | Professional | 54 · Surgery only | $363.08 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $426.58 |
Where Kentucky sits
The same service costs 6.0 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
$562
AK $2,239UT $372
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.