How much rates vary
Facilitymedian $2,291 · 10th to 90th $661 to $8,511Professionalmedian $912 · 10th to 90th $603 to $1,380
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 $537.03 Median $537.03 Typical High $8,511.38 | Facility | None | $537.03 | $537.03 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $758.58 | Professional | None | $537.03 | $537.03 | $758.58 |
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 $758.58 Median $912.01 Typical High $1,230.27 | Professional | None | $758.58 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $575.44 Typical High $776.25 | Professional | 62 · Two surgeons | $478.63 | $575.44 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $144.54 Typical High $199.53 | Professional | 80 · Assistant surgeon | $120.23 | $144.54 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $125.89 Typical High $173.78 | Professional | AS · PA/NP assist | $104.71 | $125.89 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $2,818.38 | Facility | None | $501.19 | $812.83 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $851.14 | Professional | None | $501.19 | $707.95 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,949.84 Typical High $2,290.87 | Facility | None | $741.31 | $1,949.84 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $3,630.78 | Professional | None | $524.81 | $794.33 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $933.25 | Professional | None | $676.08 | $676.08 | $933.25 |
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 $645.65 Median $1,288.25 Typical High $1,698.24 | Professional | None | $645.65 | $1,288.25 | $1,698.24 |
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 $263.03 Median $263.03 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $501.19 | Professional | 54 · Surgery only | $398.11 | $398.11 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $100.00 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $67.61 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $467.74 |
Where Kentucky sits
The same service costs 7.4 times more in Oklahoma than in New York. 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· 38th of 51
$912
OK $3,802NY $513
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.