How much rates vary
Facilitymedian $1,479 · 10th to 90th $759 to $7,586Professionalmedian $832 · 10th to 90th $661 to $1,259
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 $758.58 Median $870.96 Typical High $2,630.27 | Facility | None | $758.58 | $870.96 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $933.25 | Professional | None | $758.58 | $851.14 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $11,220.18 | Facility | None | $758.58 | $7,244.36 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,047.13 | Professional | None | $660.69 | $794.33 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $501.19 Typical High $758.58 | Professional | 62 · Two surgeons | $416.87 | $501.19 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $169.82 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $109.65 Typical High $147.91 | Professional | AS · PA/NP assist | $93.33 | $109.65 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $1,445.44 | Facility | None | $794.33 | $954.99 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,348.96 | Professional | None | $741.31 | $1,122.02 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,621.81 Typical High $4,466.84 | Facility | None | $34.67 | $1,621.81 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $4,570.88 | Professional | None | $831.76 | $1,000.00 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $398.11 | Professional | None | $33.11 | $33.11 | $398.11 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,513.56 | Professional | None | $758.58 | $977.24 | $1,513.56 |
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 $380.19 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $380.19 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $660.69 |
Where Kentucky 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.