How much rates vary
Facilitymedian $1,514 · 10th to 90th $457 to $12,023Professionalmedian $891 · 10th to 90th $724 to $1,349
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 $776.25 Median $891.25 Typical High $933.25 | Facility | None | $776.25 | $891.25 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $933.25 | Professional | None | $776.25 | $831.76 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $10,715.19 Typical High $17,782.79 | Facility | None | $6,456.54 | $10,715.19 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,174.90 | Professional | None | $724.44 | $870.96 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $549.54 Typical High $741.31 | Professional | 62 · Two surgeons | $457.09 | $549.54 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $138.04 Typical High $190.55 | Professional | 80 · Assistant surgeon | $114.82 | $138.04 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $123.03 Typical High $165.96 | Professional | AS · PA/NP assist | $100.00 | $123.03 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $870.96 Typical High $1,380.38 | Facility | None | $724.44 | $870.96 | $1,380.38 |
CareSource Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,412.54 | Professional | None | $851.14 | $1,148.15 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,513.56 | Facility | None | $34.67 | $512.86 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $4,786.30 | Professional | None | $870.96 | $1,148.15 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $562.34 | Professional | None | $33.11 | $33.11 | $562.34 |
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 $851.14 Median $1,148.15 Typical High $1,584.89 | Professional | None | $851.14 | $1,148.15 | $1,584.89 |
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 $389.05 Median $416.87 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $645.65 |
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
$891
AK $3,715TX $155
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.