How much rates vary
Facilitymedian $1,660 · 10th to 90th $794 to $4,266Professionalmedian $1,202 · 10th to 90th $955 to $1,738
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 $794.33 Median $1,148.15 Typical High $5,248.07 | Facility | None | $794.33 | $1,148.15 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,318.26 | Professional | None | $977.24 | $1,047.13 | $1,318.26 |
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 $954.99 Median $1,174.90 Typical High $1,584.89 | Professional | None | $954.99 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,778.28 Typical High $2,398.83 | Professional | 50 · Both sides | $1,445.44 | $1,778.28 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $741.31 Typical High $1,000.00 | Professional | 62 · Two surgeons | $602.56 | $741.31 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $190.55 Typical High $251.19 | Professional | 80 · Assistant surgeon | $154.88 | $190.55 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $165.96 Typical High $223.87 | Professional | AS · PA/NP assist | $134.90 | $165.96 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,737.80 | Facility | None | $1,047.13 | $1,258.93 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,412.54 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,862.09 | Facility | None | $1,000.00 | $1,148.15 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $6,918.31 | Professional | None | $1,096.48 | $1,445.44 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $616.60 | Professional | None | $33.11 | $33.11 | $616.60 |
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 $1,096.48 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,548.82 | $1,995.26 |
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 $489.78 Median $524.81 Typical High $660.69 | Professional | 52 · Reduced service | $489.78 | $524.81 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $263.03 | Professional | 53 · Discontinued | $194.98 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $794.33 Typical High $977.24 | Professional | 54 · Surgery only | $724.44 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $158.49 Typical High $199.53 | Professional | 55 · Aftercare only | $147.91 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $104.71 Typical High $131.83 | Professional | 56 · Pre-op care only | $97.72 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $741.31 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $676.08 | $741.31 | $912.01 |
Where Kentucky sits
The same service costs 6.2 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· 41st of 51
$1,202
AK $4,786UT $776
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.