How much rates vary
Facilitymedian $2,754 · 10th to 90th $457 to $13,490Professionalmedian $2,570 · 10th to 90th $2,089 to $4,266
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 $2,137.96 Median $2,511.89 Typical High $2,754.23 | Facility | None | $2,137.96 | $2,511.89 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $2,754.23 | Professional | None | $2,137.96 | $2,344.23 | $2,754.23 |
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 $2,089.30 Median $2,570.40 Typical High $3,548.13 | Professional | None | $2,089.30 | $2,570.40 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,621.81 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,318.26 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $407.38 Typical High $562.34 | Professional | 80 · Assistant surgeon | $338.84 | $407.38 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $354.81 Typical High $501.19 | Professional | AS · PA/NP assist | $295.12 | $354.81 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $3,801.89 | Facility | None | $2,041.74 | $2,454.71 | $3,801.89 |
CareSource Setting Professional Modifier None Typical Low $2,398.83 Median $3,388.44 Typical High $3,981.07 | Professional | None | $2,398.83 | $3,388.44 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $4,365.16 | Facility | None | $34.67 | $691.83 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $3,548.13 Typical High $14,454.40 | Professional | None | $2,454.71 | $3,548.13 | $14,454.40 |
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 $2,511.89 Median $3,235.94 Typical High $4,677.35 | Professional | None | $2,511.89 | $3,235.94 | $4,677.35 |
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 $1,071.52 Median $1,174.90 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,071.52 | $1,174.90 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $467.74 Typical High $549.54 | Professional | 53 · Discontinued | $436.52 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,778.28 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,621.81 | $1,778.28 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $354.81 Typical High $416.87 | Professional | 55 · Aftercare only | $323.59 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $234.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $213.80 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,659.59 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,659.59 | $1,949.84 |
Where Kentucky sits
The same service costs 17.0 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· 43rd of 51
$2,570
AK $10,471TX $617
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.