How much rates vary
Facilitymedian $2,570 · 10th to 90th $490 to $8,511Professionalmedian $457 · 10th to 90th $355 to $708
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 $416.87 Median $416.87 Typical High $8,511.38 | Facility | None | $416.87 | $416.87 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $562.34 | Professional | None | $416.87 | $436.52 | $562.34 |
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 $354.81 Median $457.09 Typical High $602.56 | Professional | None | $354.81 | $457.09 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $691.83 Typical High $891.25 | Professional | 50 · Both sides | $537.03 | $691.83 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $223.87 Median $288.40 Typical High $371.54 | Professional | 62 · Two surgeons | $223.87 | $288.40 | $371.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $72.44 Typical High $95.50 | Professional | 80 · Assistant surgeon | $57.54 | $72.44 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $61.66 Typical High $85.11 | Professional | AS · PA/NP assist | $50.12 | $61.66 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $645.65 Typical High $5,370.32 | Facility | None | $389.05 | $645.65 | $5,370.32 |
CareSource Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $660.69 | Professional | None | $363.08 | $562.34 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $3,981.07 | Facility | None | $707.95 | $2,290.87 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $2,570.40 | Professional | None | $407.38 | $616.60 | $2,570.40 |
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 $416.87 Median $549.54 Typical High $776.25 | Professional | None | $416.87 | $549.54 | $776.25 |
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 $208.93 Median $208.93 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $309.03 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $48.98 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $338.84 |
Where Kentucky sits
The same service costs 9.8 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· 47th of 51
$501
OK $3,236UT $331
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.