How much rates vary
Facilitymedian $1,820 · 10th to 90th $457 to $12,023Professionalmedian $912 · 10th to 90th $676 to $1,413
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 $912.01 Median $912.01 Typical High $1,071.52 | Facility | None | $912.01 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,071.52 | Professional | None | $912.01 | $977.24 | $1,071.52 |
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 $676.08 Median $812.83 Typical High $1,148.15 | Professional | None | $676.08 | $812.83 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,230.27 Typical High $1,698.24 | Professional | 50 · Both sides | $1,000.00 | $1,230.27 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $512.86 Typical High $724.44 | Professional | 62 · Two surgeons | $426.58 | $512.86 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $131.83 Typical High $181.97 | Professional | 80 · Assistant surgeon | $107.15 | $131.83 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $114.82 Typical High $158.49 | Professional | AS · PA/NP assist | $93.33 | $114.82 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,621.81 | Facility | None | $870.96 | $1,047.13 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,380.38 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,905.46 | Facility | None | $34.67 | $691.83 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $5,248.07 | Professional | None | $954.99 | $1,230.27 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $549.54 | Professional | None | $33.11 | $33.11 | $549.54 |
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 $812.83 Median $1,096.48 Typical High $1,621.81 | Professional | None | $812.83 | $1,096.48 | $1,621.81 |
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 $457.09 Median $489.78 Typical High $537.03 | Professional | 52 · Reduced service | $457.09 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $213.80 | Professional | 53 · Discontinued | $181.97 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $794.33 | Professional | 54 · Surgery only | $691.83 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $107.15 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $741.31 |
Where Kentucky sits
The same service costs 21.9 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
$912
AK $4,467TX $204
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.