How much rates vary
Facilitymedian $1,862 · 10th to 90th $832 to $6,761Professionalmedian $1,047 · 10th to 90th $851 to $1,549
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 $1,023.29 Typical High $5,248.07 | Facility | None | $794.33 | $1,023.29 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,096.48 | Professional | None | $870.96 | $933.25 | $1,096.48 |
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 $851.14 Median $1,023.29 Typical High $1,380.38 | Professional | None | $851.14 | $1,023.29 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $660.69 Typical High $954.99 | Professional | 62 · Two surgeons | $537.03 | $660.69 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $165.96 Typical High $218.78 | Professional | 80 · Assistant surgeon | $138.04 | $165.96 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $144.54 Typical High $190.55 | Professional | AS · PA/NP assist | $120.23 | $144.54 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $1,548.82 Typical High $7,762.47 | Facility | None | $831.76 | $1,548.82 | $7,762.47 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,318.26 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $7,943.28 | Facility | None | $1,584.89 | $1,862.09 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $5,754.40 | Professional | None | $1,000.00 | $1,288.25 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $575.44 | Professional | None | $33.11 | $33.11 | $575.44 |
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 $977.24 Median $1,348.96 Typical High $1,819.70 | Professional | None | $977.24 | $1,348.96 | $1,819.70 |
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 $436.52 Median $467.74 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $218.78 | Professional | 53 · Discontinued | $173.78 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $660.69 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $165.96 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $776.25 |
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· 43rd of 51
$1,072
AK $4,266UT $692
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.