How much rates vary
Facilitymedian $2,344 · 10th to 90th $457 to $13,490Professionalmedian $2,291 · 10th to 90th $1,778 to $3,388
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 $1,995.26 Median $2,344.23 Typical High $2,344.23 | Facility | None | $1,995.26 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $2,344.23 | Professional | None | $1,995.26 | $2,187.76 | $2,344.23 |
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 $1,778.28 Median $2,137.96 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,137.96 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,348.96 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,122.02 | $1,348.96 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $346.74 Typical High $478.63 | Professional | 80 · Assistant surgeon | $281.84 | $346.74 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $302.00 Typical High $416.87 | Professional | AS · PA/NP assist | $245.47 | $302.00 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $3,548.13 | Facility | None | $1,905.46 | $2,290.87 | $3,548.13 |
CareSource Setting Professional Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $3,715.35 | Professional | None | $2,454.71 | $3,019.95 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $4,073.80 | Facility | None | $34.67 | $691.83 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $12,022.64 | Professional | None | $2,290.87 | $2,884.03 | $12,022.64 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,230.27 | Professional | None | $33.11 | $33.11 | $1,230.27 |
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 $2,089.30 Median $2,951.21 Typical High $4,073.80 | Professional | None | $2,089.30 | $2,951.21 | $4,073.80 |
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 $1,000.00 Median $1,096.48 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,000.00 | $1,096.48 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $436.52 Typical High $467.74 | Professional | 53 · Discontinued | $407.38 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,659.59 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,513.56 | $1,659.59 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $331.13 Typical High $354.81 | Professional | 55 · Aftercare only | $302.00 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 56 · Pre-op care only | $199.53 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,548.82 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,548.82 | $1,659.59 |
Where Kentucky sits
The same service costs 24.0 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· 45th of 51
$2,291
AK $9,772TX $407
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.