How much rates vary
Facilitymedian $2,042 · 10th to 90th $794 to $8,128Professionalmedian $891 · 10th to 90th $708 to $1,413
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 $794.33 Median $794.33 Typical High $2,630.27 | Facility | None | $794.33 | $794.33 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,096.48 | Professional | None | $794.33 | $794.33 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,288.25 | Professional | None | $707.95 | $891.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $562.34 Typical High $812.83 | Professional | 62 · Two surgeons | $446.68 | $562.34 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $144.54 Typical High $208.93 | Professional | 80 · Assistant surgeon | $114.82 | $144.54 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $125.89 Typical High $181.97 | Professional | AS · PA/NP assist | $100.00 | $125.89 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $1,202.26 Typical High $2,818.38 | Facility | None | $741.31 | $1,202.26 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,258.93 | Professional | None | $831.76 | $1,071.52 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $2,089.30 | Facility | None | $1,318.26 | $1,862.09 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $5,754.40 | Professional | None | $776.25 | $1,202.26 | $5,754.40 |
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 $812.83 Median $1,096.48 Typical High $1,479.11 | Professional | None | $812.83 | $1,096.48 | $1,479.11 |
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 $398.11 Median $398.11 Typical High $537.03 | Professional | 52 · Reduced service | $398.11 | $398.11 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | 53 · Discontinued | $158.49 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $794.33 | Professional | 54 · Surgery only | $588.84 | $588.84 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $741.31 |
Where Kentucky sits
The same service costs 6.6 times more in Oklahoma than in Utah. 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· 46th of 51
$912
OK $3,802UT $575
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.