How much rates vary
Facilitymedian $1,230 · 10th to 90th $692 to $5,012Professionalmedian $1,175 · 10th to 90th $977 to $1,905
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 $1,174.90 Typical High $2,630.27 | Facility | None | $794.33 | $1,174.90 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,148.15 | $1,318.26 |
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 $977.24 Median $1,174.90 Typical High $1,621.81 | Professional | None | $977.24 | $1,174.90 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $741.31 Typical High $1,023.29 | Professional | 62 · Two surgeons | $616.60 | $741.31 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $190.55 Typical High $257.04 | Professional | 80 · Assistant surgeon | $154.88 | $190.55 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $165.96 Typical High $223.87 | Professional | AS · PA/NP assist | $134.90 | $165.96 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,737.80 | Facility | None | $933.25 | $1,096.48 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $977.24 Median $1,513.56 Typical High $1,778.28 | Professional | None | $977.24 | $1,513.56 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,819.70 Typical High $2,754.23 | Facility | None | $34.67 | $1,819.70 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $10,232.93 | Professional | None | $1,122.02 | $1,584.89 | $10,232.93 |
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 $1,047.13 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,621.81 | $2,187.76 |
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 $512.86 Median $562.34 Typical High $660.69 | Professional | 52 · Reduced service | $512.86 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $263.03 | Professional | 53 · Discontinued | $204.17 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $1,000.00 | Professional | 54 · Surgery only | $776.25 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $154.88 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $794.33 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $724.44 | $794.33 | $933.25 |
Where Kentucky sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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 $10,675KY $2,405
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.