How much rates vary
Facilitymedian $2,089 · 10th to 90th $457 to $13,490Professionalmedian $1,950 · 10th to 90th $1,585 to $3,162
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 $1,819.70 Median $2,041.74 Typical High $2,089.30 | Facility | None | $1,819.70 | $2,041.74 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,949.84 Typical High $2,137.96 | Professional | None | $1,819.70 | $1,949.84 | $2,137.96 |
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 $1,513.56 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,862.09 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $302.00 Typical High $436.52 | Professional | 80 · Assistant surgeon | $245.47 | $302.00 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $263.03 Typical High $380.19 | Professional | AS · PA/NP assist | $213.80 | $263.03 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $3,162.28 | Facility | None | $1,698.24 | $2,041.74 | $3,162.28 |
CareSource Setting Professional Modifier None Typical Low $2,187.76 Median $2,818.38 Typical High $3,311.31 | Professional | None | $2,187.76 | $2,818.38 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $3,630.78 | Facility | None | $34.67 | $691.83 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,818.38 Typical High $10,715.19 | Professional | None | $2,041.74 | $2,818.38 | $10,715.19 |
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 $1,949.84 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,454.71 | $3,715.35 |
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 $891.25 Median $977.24 Typical High $1,047.13 | Professional | 52 · Reduced service | $891.25 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $389.05 Typical High $416.87 | Professional | 53 · Discontinued | $363.08 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,479.11 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,348.96 | $1,479.11 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $295.12 Typical High $316.23 | Professional | 55 · Aftercare only | $269.15 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $194.98 Typical High $208.93 | Professional | 56 · Pre-op care only | $181.97 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,380.38 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,380.38 | $1,479.11 |
Where Kentucky sits
The same service costs 8.1 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· 45th of 51
$1,950
AK $8,913TX $1,096
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.