How much rates vary
Facilitymedian $2,291 · 10th to 90th $955 to $10,000Professionalmedian $912 · 10th to 90th $741 to $1,698
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 $1,047.13 Typical High $8,511.38 | Facility | None | $891.25 | $1,047.13 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,148.15 | Professional | None | $977.24 | $1,023.29 | $1,148.15 |
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 $724.44 Median $870.96 Typical High $1,202.26 | Professional | None | $724.44 | $870.96 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,318.26 Typical High $1,778.28 | Professional | 50 · Both sides | $1,096.48 | $1,318.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $141.25 Typical High $190.55 | Professional | 80 · Assistant surgeon | $114.82 | $141.25 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $165.96 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,412.54 Typical High $2,041.74 | Facility | None | $870.96 | $1,412.54 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,445.44 | Professional | None | $870.96 | $1,230.27 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,290.87 | Facility | None | $1,096.48 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $5,495.41 | Professional | None | $831.76 | $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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,584.89 | Professional | None | $812.83 | $912.01 | $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 $512.86 Typical High $524.81 | Professional | 52 · Reduced service | $489.78 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $208.93 | Professional | 53 · Discontinued | $194.98 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $758.58 Typical High $794.33 | Professional | 54 · Surgery only | $741.31 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $147.91 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $707.95 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $691.83 | $707.95 | $741.31 |
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· 41st of 51
$1,000
AK $3,981UT $550
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.