How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $11,220Professionalmedian $1,380 · 10th to 90th $1,096 to $2,138
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 $1,288.25 Median $1,445.44 Typical High $1,548.82 | Facility | None | $1,288.25 | $1,445.44 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,380.38 | $1,548.82 |
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 $1,071.52 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,318.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $831.76 Typical High $1,122.02 | Professional | 62 · Two surgeons | $676.08 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $281.84 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $181.97 Typical High $245.47 | Professional | AS · PA/NP assist | $151.36 | $181.97 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,089.30 | Facility | None | $1,122.02 | $1,348.96 | $2,089.30 |
CareSource Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,862.09 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,344.23 | Facility | None | $34.67 | $691.83 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $8,128.31 | Professional | None | $1,348.96 | $1,862.09 | $8,128.31 |
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 $1,202.26 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,862.09 | $2,630.27 |
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 $630.96 Median $676.08 Typical High $776.25 | Professional | 52 · Reduced service | $630.96 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $234.42 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $1,071.52 |
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
$1,380
AK $5,754TX $813
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.