How much rates vary
Facilitymedian $1,950 · 10th to 90th $457 to $12,882Professionalmedian $1,175 · 10th to 90th $912 to $1,950
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 $1,122.02 Median $1,258.93 Typical High $8,511.38 | Facility | None | $1,122.02 | $1,258.93 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,202.26 | $1,412.54 |
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 $891.25 Median $1,071.52 Typical High $1,659.59 | Professional | None | $891.25 | $1,071.52 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $676.08 Typical High $1,047.13 | Professional | 62 · Two surgeons | $562.34 | $676.08 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $169.82 Typical High $263.03 | Professional | 80 · Assistant surgeon | $141.25 | $169.82 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $151.36 Typical High $229.09 | Professional | AS · PA/NP assist | $123.03 | $151.36 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,819.70 | Facility | None | $977.24 | $1,174.90 | $1,819.70 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,621.81 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,949.84 | Facility | None | $34.67 | $512.86 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $7,413.10 | Professional | None | $1,174.90 | $1,737.80 | $7,413.10 |
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 $1,148.15 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,737.80 | $2,344.23 |
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 $549.54 Median $602.56 Typical High $707.95 | Professional | 52 · Reduced service | $549.54 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $281.84 | Professional | 53 · Discontinued | $218.78 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $812.83 | $891.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $213.80 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $1,000.00 |
Where Kentucky sits
The same service costs 7.1 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· 43rd of 51
$1,202
AK $5,012TX $708
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.