How much rates vary
Facilitymedian $2,188 · 10th to 90th $398 to $8,318Professionalmedian $309 · 10th to 90th $240 to $501
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 $302.00 Median $363.08 Typical High $8,511.38 | Facility | None | $302.00 | $363.08 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $398.11 | Professional | None | $288.40 | $302.00 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $239.88 Median $309.03 Typical High $478.63 | Professional | None | $239.88 | $309.03 | $478.63 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $151.36 Median $194.98 Typical High $302.00 | Professional | 62 · Two surgeons | $151.36 | $194.98 | $302.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $50.12 Typical High $77.62 | Professional | 80 · Assistant surgeon | $38.02 | $50.12 | $77.62 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $43.65 Typical High $67.61 | Professional | AS · PA/NP assist | $33.11 | $43.65 | $67.61 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $1,621.81 | Facility | None | $229.09 | $436.52 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $446.68 | Professional | None | $263.03 | $380.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,122.02 Typical High $2,290.87 | Facility | None | $478.63 | $1,122.02 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $2,089.30 | Professional | None | $275.42 | $416.87 | $2,089.30 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $524.81 | Professional | None | $263.03 | $380.19 | $524.81 |
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 $144.54 Median $151.36 Typical High $194.98 | Professional | 52 · Reduced service | $144.54 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $79.43 | Professional | 53 · Discontinued | $57.54 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $295.12 | Professional | 54 · Surgery only | $213.80 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $58.88 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $208.93 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $199.53 | $208.93 | $275.42 |
Where Kentucky sits
The same service costs 6.6 times more in Oklahoma than in Montana. 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 $6,126MT $925
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.