How much rates vary
Facilitymedian $955 · 10th to 90th $479 to $5,623Professionalmedian $245 · 10th to 90th $174 to $589
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 $478.63 Median $549.54 Typical High $3,801.89 | Facility | None | $478.63 | $549.54 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $602.56 | Professional | None | $478.63 | $512.86 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $275.42 | Professional | None | $173.78 | $213.80 | $275.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $316.23 Typical High $416.87 | Professional | 50 · Both sides | $263.03 | $316.23 | $416.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $109.65 Median $131.83 Typical High $173.78 | Professional | 62 · Two surgeons | $109.65 | $131.83 | $173.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.18 Median $33.11 Typical High $45.71 | Professional | 80 · Assistant surgeon | $28.18 | $33.11 | $45.71 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $24.55 Median $29.51 Typical High $38.90 | Professional | AS · PA/NP assist | $24.55 | $29.51 | $38.90 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $851.14 | Facility | None | $446.68 | $537.03 | $851.14 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $870.96 | Professional | None | $524.81 | $707.95 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $954.99 Typical High $4,073.80 | Facility | None | $34.67 | $954.99 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $3,890.45 | Professional | None | $512.86 | $691.83 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $537.03 | Professional | None | $281.84 | $407.38 | $537.03 |
5 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 $239.88 Median $257.04 Typical High $295.12 | Professional | 52 · Reduced service | $239.88 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $354.81 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $89.13 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $60.26 |
Where Kentucky sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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· 50th of 51
$245
AK $2,344HI $224
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.