How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $13,490Professionalmedian $1,318 · 10th to 90th $1,047 to $2,138
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 $1,148.15 Median $1,318.26 Typical High $1,412.54 | Facility | None | $1,148.15 | $1,318.26 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,230.27 | $1,412.54 |
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 $1,023.29 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,288.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $812.83 Typical High $1,148.15 | Professional | 62 · Two surgeons | $645.65 | $812.83 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $295.12 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $177.83 Typical High $257.04 | Professional | AS · PA/NP assist | $144.54 | $177.83 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,041.74 | Facility | None | $1,071.52 | $1,288.25 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,778.28 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,344.23 | Facility | None | $34.67 | $691.83 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $7,413.10 | Professional | None | $1,288.25 | $1,819.70 | $7,413.10 |
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 $1,288.25 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,698.24 | $2,454.71 |
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 $575.44 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $575.44 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $229.09 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $933.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $851.14 | $933.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $169.82 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $794.33 | $870.96 | $977.24 |
Where Kentucky sits
The same service costs 5.8 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· 47th of 51
$1,349
AK $5,623TX $977
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.