How much rates vary
Facilitymedian $1,862 · 10th to 90th $457 to $13,490Professionalmedian $1,072 · 10th to 90th $759 to $1,698
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 $912.01 Median $1,000.00 Typical High $1,174.90 | Facility | None | $912.01 | $1,000.00 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,071.52 | $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 $741.31 Median $977.24 Typical High $1,318.26 | Professional | None | $741.31 | $977.24 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $616.60 Typical High $812.83 | Professional | 62 · Two surgeons | $467.74 | $616.60 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $154.88 Typical High $208.93 | Professional | 80 · Assistant surgeon | $120.23 | $154.88 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $138.04 Typical High $181.97 | Professional | AS · PA/NP assist | $104.71 | $138.04 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,778.28 | Facility | None | $954.99 | $1,148.15 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,548.82 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,089.30 | Facility | None | $34.67 | $512.86 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $8,912.51 | Professional | None | $1,148.15 | $1,412.54 | $8,912.51 |
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 $933.25 Median $1,202.26 Typical High $2,041.74 | Professional | None | $933.25 | $1,202.26 | $2,041.74 |
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 $501.19 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $794.33 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $741.31 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $741.31 | $812.83 |
Where Kentucky sits
The same service costs 5.6 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
$1,072
AK $5,012UT $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.