How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,175 to $13,490Professionalmedian $1,514 · 10th to 90th $794 to $2,239
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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $891.25 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,621.81 Typical High $2,238.72 | Professional | None | $851.14 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $1,000.00 Typical High $1,412.54 | Professional | 62 · Two surgeons | $524.81 | $1,000.00 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $269.15 Typical High $363.08 | Professional | 80 · Assistant surgeon | $131.83 | $269.15 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $223.87 Typical High $316.23 | Professional | AS · PA/NP assist | $114.82 | $223.87 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $7,762.47 Typical High $14,125.38 | Facility | None | $2,187.76 | $7,762.47 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,258.93 | $2,089.30 |
ConnectiCare Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,479.11 | Professional | None | $891.25 | $1,148.15 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,230.27 Typical High $2,398.83 | Professional | None | $660.69 | $1,230.27 | $2,398.83 |
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 $446.68 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $446.68 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $177.83 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $676.08 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $134.90 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $89.13 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $630.96 | $912.01 | $912.01 |
Where Connecticut sits
The same service costs 5.1 times more in Oklahoma than in Kentucky. 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
OK $11,738KY $2,311
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.