How much rates vary
Facilitymedian $2,455 · 10th to 90th $933 to $8,318Professionalmedian $1,288 · 10th to 90th $1,072 to $1,950
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 $1,288.25 Typical High $2,630.27 | Facility | None | $794.33 | $1,288.25 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,174.90 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,288.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $812.83 Typical High $1,096.48 | Professional | 62 · Two surgeons | $676.08 | $812.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $208.93 Typical High $281.84 | Professional | 80 · Assistant surgeon | $169.82 | $208.93 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $181.97 Typical High $245.47 | Professional | AS · PA/NP assist | $147.91 | $181.97 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $5,248.07 | Facility | None | $1,174.90 | $1,949.84 | $5,248.07 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,659.59 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $5,011.87 | Facility | None | $1,819.70 | $2,290.87 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $6,760.83 | Professional | None | $1,258.93 | $1,621.81 | $6,760.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $741.31 | Professional | None | $33.11 | $33.11 | $741.31 |
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 $1,230.27 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,737.80 | $2,290.87 |
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 $549.54 Median $588.84 Typical High $660.69 | Professional | 52 · Reduced service | $549.54 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $977.24 | Professional | 54 · Surgery only | $831.76 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $194.98 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $831.76 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $776.25 | $831.76 | $912.01 |
Where Kentucky sits
The same service costs 11.0 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· 42nd of 51
$1,318
AK $5,370TX $490
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.