How much rates vary
Facilitymedian $1,778 · 10th to 90th $251 to $7,586Professionalmedian $912 · 10th to 90th $741 to $1,660
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 $2,630.27 | Facility | None | $794.33 | $1,023.29 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,148.15 | Professional | None | $977.24 | $1,000.00 | $1,148.15 |
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 $707.95 Median $870.96 Typical High $1,202.26 | Professional | None | $707.95 | $870.96 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,288.25 Typical High $1,778.28 | Professional | 50 · Both sides | $1,071.52 | $1,288.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $138.04 Typical High $190.55 | Professional | 80 · Assistant surgeon | $114.82 | $138.04 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $120.23 Typical High $165.96 | Professional | AS · PA/NP assist | $100.00 | $120.23 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $2,041.74 | Facility | None | $741.31 | $1,412.54 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,445.44 | Professional | None | $870.96 | $1,174.90 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,290.87 | Facility | None | $1,318.26 | $1,445.44 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $5,495.41 | Professional | None | $812.83 | $1,174.90 | $5,495.41 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,584.89 | Professional | None | $794.33 | $891.25 | $1,584.89 |
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 $501.19 Typical High $524.81 | Professional | 52 · Reduced service | $489.78 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $208.93 | Professional | 53 · Discontinued | $194.98 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $776.25 | Professional | 54 · Surgery only | $724.44 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $154.88 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $104.71 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $724.44 |
Where Kentucky sits
The same service costs 7.2 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
$955
AK $3,890UT $537
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.