How much rates vary
Facilitymedian $1,585 · 10th to 90th $631 to $9,333Professionalmedian $692 · 10th to 90th $550 to $1,175
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 $645.65 Median $707.95 Typical High $2,630.27 | Facility | None | $645.65 | $707.95 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $724.44 | Professional | None | $630.96 | $691.83 | $724.44 |
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 $549.54 Median $676.08 Typical High $977.24 | Professional | None | $549.54 | $676.08 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,000.00 Typical High $1,412.54 | Professional | 50 · Both sides | $831.76 | $1,000.00 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $426.58 Typical High $602.56 | Professional | 62 · Two surgeons | $346.74 | $426.58 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $107.15 Typical High $144.54 | Professional | 80 · Assistant surgeon | $89.13 | $107.15 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $93.33 Typical High $131.83 | Professional | AS · PA/NP assist | $77.62 | $93.33 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $1,548.82 Typical High $2,754.23 | Facility | None | $645.65 | $1,548.82 | $2,754.23 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,096.48 | Professional | None | $660.69 | $933.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,122.02 | Facility | None | $34.67 | $512.86 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $3,715.35 | Professional | None | $676.08 | $977.24 | $3,715.35 |
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 $630.96 Median $1,000.00 Typical High $1,318.26 | Professional | None | $630.96 | $1,000.00 | $1,318.26 |
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 $316.23 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $501.19 |
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· 45th of 51
$708
AK $2,884TX $417
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.