How much rates vary
Facilitymedian $1,288 · 10th to 90th $550 to $7,586Professionalmedian $676 · 10th to 90th $537 to $1,096
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 $549.54 Median $676.08 Typical High $933.25 | Facility | None | $549.54 | $676.08 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $933.25 | Professional | None | $549.54 | $630.96 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,258.93 | Professional | None | $707.95 | $870.96 | $1,258.93 |
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 $537.03 Median $676.08 Typical High $1,096.48 | Professional | None | $537.03 | $676.08 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,023.29 Typical High $1,621.81 | Professional | 50 · Both sides | $812.83 | $1,023.29 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $426.58 Typical High $691.83 | Professional | 62 · Two surgeons | $338.84 | $426.58 | $691.83 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $1,071.52 Typical High $1,778.28 | Facility | None | $575.44 | $1,071.52 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $977.24 | Professional | None | $549.54 | $812.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,047.13 Typical High $1,949.84 | Facility | None | $34.67 | $1,047.13 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $4,897.79 | Professional | None | $616.60 | $831.76 | $4,897.79 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $363.08 | Professional | None | $33.11 | $33.11 | $363.08 |
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 $630.96 Median $794.33 Typical High $1,148.15 | Professional | None | $630.96 | $794.33 | $1,148.15 |
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 $275.42 Median $316.23 Typical High $398.11 | Professional | 52 · Reduced service | $275.42 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $125.89 Typical High $158.49 | Professional | 53 · Discontinued | $109.65 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $602.56 | Professional | 54 · Surgery only | $416.87 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $95.50 Typical High $120.23 | Professional | 55 · Aftercare only | $83.18 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $63.10 Typical High $79.43 | Professional | 56 · Pre-op care only | $54.95 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $562.34 |
Where Kentucky sits
The same service costs 7.6 times more in Oklahoma than in Texas. 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 $11,248TX $1,472
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.