How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,096 to $10,471Professionalmedian $1,259 · 10th to 90th $1,023 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 $891.25 Median $1,412.54 Typical High $8,511.38 | Facility | None | $891.25 | $1,412.54 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,380.38 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $2,511.89 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $758.58 Typical High $1,071.52 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $194.98 Typical High $263.03 | Professional | 80 · Assistant surgeon | $158.49 | $194.98 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $234.42 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,174.90 | $1,905.46 | $6,025.60 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,659.59 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,479.11 | $1,479.11 | $2,511.89 |
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 $851.14 Median $2,511.89 Typical High $6,760.83 | Facility | None | $851.14 | $2,511.89 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,258.93 | $2,187.76 |
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 $660.69 Median $691.83 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $288.40 | Professional | 53 · Discontinued | $263.03 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,071.52 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $204.17 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $144.54 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $1,000.00 |
Where Kentucky sits
The same service costs 8.3 times more in Wyoming 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
$1,318
WY $5,623UT $676
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.