How much rates vary
Facilitymedian $832 · 10th to 90th $302 to $9,333Professionalmedian $295 · 10th to 90th $234 to $513
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 $302.00 Median $338.84 Typical High $5,248.07 | Facility | None | $302.00 | $338.84 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $398.11 | Professional | None | $295.12 | $323.59 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $229.09 Median $275.42 Typical High $426.58 | Professional | None | $229.09 | $275.42 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $36.31 Median $43.65 Typical High $64.57 | Professional | 80 · Assistant surgeon | $36.31 | $43.65 | $64.57 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $38.02 Typical High $60.26 | Professional | AS · PA/NP assist | $31.62 | $38.02 | $60.26 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $316.23 Typical High $501.19 | Facility | None | $263.03 | $316.23 | $501.19 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $512.86 | Professional | None | $302.00 | $436.52 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $794.33 | Facility | None | $34.67 | $512.86 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $1,949.84 | Professional | None | $323.59 | $457.09 | $1,949.84 |
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 $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $630.96 | Professional | None | $302.00 | $457.09 | $630.96 |
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 $147.91 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $147.91 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $75.86 | Professional | 53 · Discontinued | $58.88 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $239.88 Typical High $281.84 | Professional | 54 · Surgery only | $218.78 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $223.87 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $204.17 | $223.87 | $263.03 |
Where Kentucky sits
The same service costs 5.8 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· 49th of 51
$316
AK $1,380UT $240
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.