How much rates vary
Facilitymedian $2,455 · 10th to 90th $977 to $10,000Professionalmedian $1,230 · 10th to 90th $933 to $2,138
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 $1,380.38 Typical High $8,511.38 | Facility | None | $891.25 | $1,380.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,445.44 | Professional | None | $1,318.26 | $1,348.96 | $1,445.44 |
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 $912.01 Median $1,096.48 Typical High $1,513.56 | Professional | None | $912.01 | $1,096.48 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,659.59 Typical High $2,238.72 | Professional | 50 · Both sides | $1,380.38 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $691.83 Typical High $954.99 | Professional | 62 · Two surgeons | $575.44 | $691.83 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $177.83 Typical High $239.88 | Professional | 80 · Assistant surgeon | $147.91 | $177.83 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $208.93 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $3,388.44 | Facility | None | $1,174.90 | $1,905.46 | $3,388.44 |
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 Facility Modifier None Typical Low $1,513.56 Median $2,290.87 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,290.87 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $7,244.36 | Professional | None | $1,122.02 | $1,548.82 | $7,244.36 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,148.15 | $1,995.26 |
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 $676.08 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $269.15 Typical High $288.40 | Professional | 53 · Discontinued | $263.03 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $134.90 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,000.00 |
Where Kentucky sits
The same service costs 7.1 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
$1,288
AK $5,370UT $759
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.