How much rates vary
Facilitymedian $2,630 · 10th to 90th $457 to $13,490Professionalmedian $2,455 · 10th to 90th $1,950 to $3,890
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 $2,089.30 Median $2,454.71 Typical High $2,630.27 | Facility | None | $2,089.30 | $2,454.71 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,290.87 | $2,630.27 |
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 $1,905.46 Median $2,344.23 Typical High $3,388.44 | Professional | None | $1,905.46 | $2,344.23 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,445.44 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,202.26 | $1,445.44 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $371.54 Typical High $537.03 | Professional | 80 · Assistant surgeon | $309.03 | $371.54 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $323.59 Typical High $478.63 | Professional | AS · PA/NP assist | $269.15 | $323.59 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $3,715.35 | Facility | None | $1,995.26 | $2,398.83 | $3,715.35 |
CareSource Setting Professional Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $3,890.45 | Professional | None | $2,570.40 | $3,235.94 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $4,168.69 | Facility | None | $34.67 | $691.83 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $3,311.31 Typical High $13,803.84 | Professional | None | $2,398.83 | $3,311.31 | $13,803.84 |
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 $2,344.23 Median $3,090.30 Typical High $4,466.84 | Professional | None | $2,344.23 | $3,090.30 | $4,466.84 |
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 $1,047.13 Median $1,148.15 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,047.13 | $1,148.15 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $457.09 Typical High $524.81 | Professional | 53 · Discontinued | $416.87 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,698.24 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,584.89 | $1,698.24 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $338.84 Typical High $398.11 | Professional | 55 · Aftercare only | $316.23 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $229.09 Typical High $263.03 | Professional | 56 · Pre-op care only | $208.93 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,584.89 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,584.89 | $1,862.09 |
Where Kentucky sits
The same service costs 10.0 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
$2,455
AK $10,233TX $1,023
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.