How much rates vary
Facilitymedian $2,239 · 10th to 90th $457 to $13,490Professionalmedian $2,138 · 10th to 90th $1,738 to $3,548
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 $1,819.70 Median $2,137.96 Typical High $2,238.72 | Facility | None | $1,819.70 | $2,137.96 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $2,238.72 | Professional | None | $1,819.70 | $1,995.26 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $10,715.19 Typical High $19,498.45 | Facility | None | $7,244.36 | $10,715.19 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,737.80 | $2,137.96 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,348.96 Typical High $1,905.46 | Professional | 62 · Two surgeons | $1,096.48 | $1,348.96 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $338.84 Typical High $478.63 | Professional | 80 · Assistant surgeon | $281.84 | $338.84 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $295.12 Typical High $416.87 | Professional | AS · PA/NP assist | $245.47 | $295.12 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $3,235.94 | Facility | None | $1,737.80 | $2,089.30 | $3,235.94 |
CareSource Setting Professional Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,884.03 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $3,715.35 | Facility | None | $34.67 | $691.83 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $3,019.95 Typical High $11,748.98 | Professional | None | $2,089.30 | $3,019.95 | $11,748.98 |
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 $2,137.96 Median $2,754.23 Typical High $3,890.45 | Professional | None | $2,137.96 | $2,754.23 | $3,890.45 |
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 $912.01 Median $1,000.00 Typical High $1,122.02 | Professional | 52 · Reduced service | $912.01 | $1,000.00 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $398.11 Typical High $457.09 | Professional | 53 · Discontinued | $363.08 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,479.11 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,380.38 | $1,479.11 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $302.00 Typical High $338.84 | Professional | 55 · Aftercare only | $275.42 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $199.53 Typical High $223.87 | Professional | 56 · Pre-op care only | $181.97 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,380.38 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,380.38 | $1,584.89 |
Where Kentucky sits
The same service costs 13.5 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· 42nd of 51
$2,188
AK $8,913TX $661
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.