How much rates vary
Facilitymedian $1,549 · 10th to 90th $794 to $8,511Professionalmedian $1,175 · 10th to 90th $933 to $2,042
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 $891.25 Median $1,318.26 Typical High $8,511.38 | Facility | None | $891.25 | $1,318.26 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,258.93 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $11,220.18 | Facility | None | $758.58 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,737.80 | Professional | None | $912.01 | $1,096.48 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $691.83 Typical High $1,071.52 | Professional | 62 · Two surgeons | $575.44 | $691.83 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $173.78 Typical High $275.42 | Professional | 80 · Assistant surgeon | $158.49 | $173.78 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $239.88 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,949.84 | Facility | None | $1,023.29 | $1,230.27 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,698.24 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,041.74 Typical High $3,890.45 | Facility | None | $34.67 | $2,041.74 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $7,943.28 | Professional | None | $1,258.93 | $1,819.70 | $7,943.28 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,819.70 | $2,454.71 |
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 $575.44 Median $630.96 Typical High $758.58 | Professional | 52 · Reduced service | $575.44 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $302.00 | Professional | 53 · Discontinued | $229.09 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $1,148.15 | Professional | 54 · Surgery only | $870.96 | $954.99 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $151.36 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $891.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $812.83 | $891.25 | $1,071.52 |
Where Kentucky sits
The same service costs 6.9 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· 48th of 51
$1,175
AK $5,370TX $776
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.