How much rates vary
Facilitymedian $1,862 · 10th to 90th $832 to $5,012Professionalmedian $955 · 10th to 90th $794 to $1,514
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 $831.76 Median $954.99 Typical High $2,290.87 | Facility | None | $831.76 | $954.99 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,380.38 | Professional | None | $831.76 | $933.25 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $794.33 Median $954.99 Typical High $1,288.25 | Professional | None | $794.33 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $602.56 Typical High $812.83 | Professional | 62 · Two surgeons | $501.19 | $602.56 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $154.88 Typical High $208.93 | Professional | 80 · Assistant surgeon | $125.89 | $154.88 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $134.90 Typical High $181.97 | Professional | AS · PA/NP assist | $112.20 | $134.90 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $1,479.11 Typical High $5,248.07 | Facility | None | $776.25 | $1,479.11 | $5,248.07 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,513.56 | Professional | None | $912.01 | $1,230.27 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,862.09 Typical High $5,011.87 | Facility | None | $1,096.48 | $1,862.09 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $5,623.41 | Professional | None | $954.99 | $1,258.93 | $5,623.41 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $512.86 | Professional | None | $33.11 | $33.11 | $512.86 |
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 $933.25 Median $1,288.25 Typical High $1,737.80 | Professional | None | $933.25 | $1,288.25 | $1,737.80 |
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 $416.87 Median $446.68 Typical High $537.03 | Professional | 52 · Reduced service | $416.87 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $213.80 | Professional | 53 · Discontinued | $165.96 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $794.33 | Professional | 54 · Surgery only | $616.60 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $107.15 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $741.31 |
Where Kentucky sits
The same service costs 4.4 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 $10,992HI $2,489
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.