How much rates vary
Facilitymedian $1,072 · 10th to 90th $525 to $7,244Professionalmedian $603 · 10th to 90th $490 to $912
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 $524.81 Median $616.60 Typical High $794.33 | Facility | None | $524.81 | $616.60 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $630.96 | Professional | None | $524.81 | $575.44 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $851.14 | Professional | None | $467.74 | $602.56 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $891.25 Typical High $1,288.25 | Professional | 50 · Both sides | $707.95 | $891.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $95.50 Typical High $134.90 | Professional | 80 · Assistant surgeon | $74.13 | $95.50 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $83.18 Typical High $120.23 | Professional | AS · PA/NP assist | $66.07 | $83.18 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $933.25 Typical High $1,995.26 | Facility | None | $562.34 | $933.25 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $977.24 | Professional | None | $588.84 | $776.25 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,071.52 Typical High $1,479.11 | Facility | None | $34.67 | $1,071.52 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $3,311.31 | Professional | None | $602.56 | $776.25 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $354.81 | Professional | None | $33.11 | $33.11 | $354.81 |
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 $588.84 Median $758.58 Typical High $1,096.48 | Professional | None | $588.84 | $758.58 | $1,096.48 |
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 $263.03 Median $288.40 Typical High $316.23 | Professional | 52 · Reduced service | $263.03 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $107.15 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $398.11 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $371.54 | $398.11 | $436.52 |
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· 46th of 51
$617
AK $2,570UT $447
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.