How much rates vary
Facilitymedian $2,138 · 10th to 90th $891 to $8,318Professionalmedian $1,072 · 10th to 90th $813 to $1,698
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 $933.25 Typical High $2,630.27 | Facility | None | $794.33 | $933.25 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,479.11 | Professional | None | $933.25 | $977.24 | $1,479.11 |
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 $812.83 Median $1,071.52 Typical High $1,513.56 | Professional | None | $812.83 | $1,071.52 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $676.08 Typical High $954.99 | Professional | 62 · Two surgeons | $512.86 | $676.08 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $169.82 Typical High $245.47 | Professional | 80 · Assistant surgeon | $128.82 | $169.82 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $144.54 Typical High $194.98 | Professional | AS · PA/NP assist | $112.20 | $144.54 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,445.44 Typical High $2,818.38 | Facility | None | $870.96 | $1,445.44 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,479.11 | Professional | None | $870.96 | $1,202.26 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,089.30 | Facility | None | $1,548.82 | $1,862.09 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $6,606.93 | Professional | None | $912.01 | $1,445.44 | $6,606.93 |
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 $954.99 Median $1,288.25 Typical High $1,737.80 | Professional | None | $954.99 | $1,288.25 | $1,737.80 |
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 $467.74 Median $467.74 Typical High $630.96 | Professional | 52 · Reduced service | $467.74 | $467.74 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $251.19 | Professional | 53 · Discontinued | $186.21 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $954.99 | Professional | 54 · Surgery only | $691.83 | $691.83 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $891.25 |
Where Kentucky sits
The same service costs 5.9 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· 41st of 51
$1,175
OK $4,074UT $692
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.