How much rates vary
Facilitymedian $1,318 · 10th to 90th $513 to $12,023Professionalmedian $1,202 · 10th to 90th $977 to $1,905
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 $1,023.29 Median $1,174.90 Typical High $1,202.26 | Facility | None | $1,023.29 | $1,174.90 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,122.02 | $1,230.27 |
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 $954.99 Median $1,148.15 Typical High $1,621.81 | Professional | None | $954.99 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $724.44 Typical High $1,047.13 | Professional | 62 · Two surgeons | $602.56 | $724.44 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $186.21 Typical High $263.03 | Professional | 80 · Assistant surgeon | $151.36 | $186.21 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $162.18 Typical High $229.09 | Professional | AS · PA/NP assist | $134.90 | $162.18 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,819.70 | Facility | None | $977.24 | $1,174.90 | $1,819.70 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,621.81 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,137.96 | Facility | None | $34.67 | $691.83 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $6,165.95 | Professional | None | $1,174.90 | $1,659.59 | $6,165.95 |
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 $1,148.15 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,513.56 | $2,187.76 |
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 $512.86 Median $562.34 Typical High $602.56 | Professional | 52 · Reduced service | $512.86 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $831.76 Typical High $912.01 | Professional | 54 · Surgery only | $776.25 | $831.76 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $165.96 Typical High $181.97 | Professional | 55 · Aftercare only | $154.88 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $776.25 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $724.44 | $776.25 | $851.14 |
Where Kentucky sits
The same service costs 5.6 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
$1,202
AK $5,012TX $891
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.