How much rates vary
Facilitymedian $1,549 · 10th to 90th $447 to $4,169Professionalmedian $447 · 10th to 90th $363 to $676
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 $380.19 Median $436.52 Typical High $5,248.07 | Facility | None | $380.19 | $436.52 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $446.68 | Professional | None | $380.19 | $407.38 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $562.34 | Professional | None | $363.08 | $426.58 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $645.65 Typical High $831.76 | Professional | 50 · Both sides | $549.54 | $645.65 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $69.18 Typical High $89.13 | Professional | 80 · Assistant surgeon | $58.88 | $69.18 | $89.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $60.26 Typical High $77.62 | Professional | AS · PA/NP assist | $51.29 | $60.26 | $77.62 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $676.08 Typical High $1,548.82 | Facility | None | $416.87 | $676.08 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $691.83 | Professional | None | $416.87 | $562.34 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $1,659.59 | Facility | None | $524.81 | $1,071.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $2,290.87 | Professional | None | $426.58 | $575.44 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $239.88 | Professional | None | $33.11 | $33.11 | $239.88 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $776.25 | Professional | None | $426.58 | $588.84 | $776.25 |
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 $190.55 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $302.00 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $60.26 Typical High $66.07 | Professional | 55 · Aftercare only | $56.23 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $281.84 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $263.03 | $281.84 | $309.03 |
Where Kentucky sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$457
AK $1,862UT $324
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.