How much rates vary
Facilitymedian $1,778 · 10th to 90th $851 to $6,026Professionalmedian $1,096 · 10th to 90th $891 to $1,622
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 $1,047.13 Typical High $5,248.07 | Facility | None | $794.33 | $1,047.13 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,174.90 | Professional | None | $891.25 | $954.99 | $1,174.90 |
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 $891.25 Median $1,071.52 Typical High $1,479.11 | Professional | None | $891.25 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $173.78 Typical High $234.42 | Professional | 80 · Assistant surgeon | $144.54 | $173.78 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $151.36 Typical High $204.17 | Professional | AS · PA/NP assist | $125.89 | $151.36 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $6,606.93 | Facility | None | $954.99 | $1,584.89 | $6,606.93 |
CareSource Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,348.96 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $6,606.93 | Facility | None | $1,174.90 | $1,698.24 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $6,165.95 | Professional | None | $1,023.29 | $1,348.96 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $630.96 | Professional | None | $33.11 | $33.11 | $630.96 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,380.38 | $1,862.09 |
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 $446.68 Median $478.63 Typical High $588.84 | Professional | 52 · Reduced service | $446.68 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $234.42 | Professional | 53 · Discontinued | $177.83 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $891.25 | Professional | 54 · Surgery only | $676.08 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $177.83 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $117.49 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $831.76 |
Where Kentucky sits
The same service costs 4.6 times more in Alaska than in Hawaii. 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.
Physician feeFacility fee
AK $11,951HI $2,608
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.