How much rates vary
Facilitymedian $1,122 · 10th to 90th $550 to $7,244Professionalmedian $617 · 10th to 90th $513 to $1,000
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 $549.54 Median $616.60 Typical High $794.33 | Facility | None | $549.54 | $616.60 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $691.83 | Professional | None | $537.03 | $588.84 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $870.96 | Professional | None | $489.78 | $616.60 | $870.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $389.05 Typical High $549.54 | Professional | 62 · Two surgeons | $309.03 | $389.05 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $100.00 Typical High $141.25 | Professional | 80 · Assistant surgeon | $79.43 | $100.00 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $87.10 Typical High $123.03 | Professional | AS · PA/NP assist | $69.18 | $87.10 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $1,230.27 Typical High $1,995.26 | Facility | None | $549.54 | $1,230.27 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $933.25 | Professional | None | $575.44 | $794.33 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $977.24 Typical High $2,754.23 | Facility | None | $34.67 | $977.24 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $3,548.13 | Professional | None | $588.84 | $831.76 | $3,548.13 |
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 $549.54 Median $831.76 Typical High $1,148.15 | Professional | None | $549.54 | $831.76 | $1,148.15 |
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 $269.15 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $109.65 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $512.86 | Professional | 54 · Surgery only | $407.38 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $478.63 |
Where Kentucky sits
The same service costs 6.2 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
$631
AK $2,512UT $407
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.