How much rates vary
Facilitymedian $2,042 · 10th to 90th $692 to $8,128Professionalmedian $759 · 10th to 90th $589 to $1,230
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 $691.83 Median $691.83 Typical High $2,630.27 | Facility | None | $691.83 | $691.83 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $977.24 | Professional | None | $691.83 | $691.83 | $977.24 |
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 $588.84 Median $741.31 Typical High $1,122.02 | Professional | None | $588.84 | $741.31 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $467.74 Typical High $707.95 | Professional | 62 · Two surgeons | $371.54 | $467.74 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $117.49 Typical High $181.97 | Professional | 80 · Assistant surgeon | $95.50 | $117.49 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $104.71 Typical High $158.49 | Professional | AS · PA/NP assist | $83.18 | $104.71 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $1,047.13 Typical High $2,818.38 | Facility | None | $562.34 | $1,047.13 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,096.48 | Professional | None | $724.44 | $933.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $2,089.30 | Facility | None | $1,148.15 | $1,862.09 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $5,128.61 | Professional | None | $676.08 | $1,047.13 | $5,128.61 |
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 $933.25 Typical High $1,288.25 | Professional | None | $691.83 | $933.25 | $1,288.25 |
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 $346.74 Median $346.74 Typical High $467.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | 53 · Discontinued | $138.04 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | 54 · Surgery only | $512.86 | $512.86 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $645.65 |
Where Kentucky sits
The same service costs 7.2 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· 42nd of 51
$851
OK $3,802UT $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.