How much rates vary
Facilitymedian $1,479 · 10th to 90th $646 to $3,548Professionalmedian $692 · 10th to 90th $550 to $1,202
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 $645.65 Median $812.83 Typical High $3,801.89 | Facility | None | $645.65 | $812.83 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,023.29 | Professional | None | $741.31 | $812.83 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $933.25 | Professional | None | $549.54 | $645.65 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $104.71 Typical High $165.96 | Professional | 80 · Assistant surgeon | $87.10 | $104.71 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $91.20 Typical High $144.54 | Professional | AS · PA/NP assist | $75.86 | $91.20 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $5,495.41 | Facility | None | $707.95 | $1,174.90 | $5,495.41 |
CareSource Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,202.26 | Professional | None | $794.33 | $1,023.29 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,318.26 Typical High $3,235.94 | Facility | None | $870.96 | $1,318.26 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $3,467.37 | Professional | None | $741.31 | $1,096.48 | $3,467.37 |
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 $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,412.54 | Professional | None | $691.83 | $1,023.29 | $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 $371.54 Median $407.38 Typical High $512.86 | Professional | 52 · Reduced service | $371.54 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $208.93 | Professional | 53 · Discontinued | $147.91 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $776.25 | Professional | 54 · Surgery only | $562.34 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $154.88 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $102.33 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $724.44 |
Where Kentucky sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $1,932
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.