How much rates vary
Facilitymedian $2,754 · 10th to 90th $794 to $8,511Professionalmedian $794 · 10th to 90th $631 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 $776.25 Median $794.33 Typical High $8,511.38 | Facility | None | $776.25 | $794.33 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $1,023.29 | Professional | None | $776.25 | $794.33 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,071.52 | Professional | None | $630.96 | $776.25 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,148.15 Typical High $1,584.89 | Professional | 50 · Both sides | $933.25 | $1,148.15 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $478.63 Typical High $676.08 | Professional | 62 · Two surgeons | $398.11 | $478.63 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $123.03 Typical High $169.82 | Professional | 80 · Assistant surgeon | $100.00 | $123.03 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $107.15 Typical High $147.91 | Professional | AS · PA/NP assist | $87.10 | $107.15 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $1,202.26 Typical High $4,897.79 | Facility | None | $741.31 | $1,202.26 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,230.27 | Professional | None | $812.83 | $1,047.13 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $3,630.78 | Facility | None | $1,288.25 | $2,290.87 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $4,168.69 | Professional | None | $776.25 | $1,071.52 | $4,168.69 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,412.54 | Professional | None | $707.95 | $933.25 | $1,412.54 |
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 $389.05 Median $398.11 Typical High $457.09 | Professional | 52 · Reduced service | $389.05 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $154.88 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $588.84 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $77.62 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $630.96 |
Where Kentucky sits
The same service costs 7.4 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.
Kentucky· 45th of 51
$832
OK $3,890TX $525
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.