How much rates vary
Facilitymedian $3,715 · 10th to 90th $468 to $12,303Professionalmedian $457 · 10th to 90th $355 to $692
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 $7,943.28 | Facility | None | $416.87 | $416.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | None | $416.87 | $416.87 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $14,454.40 | Facility | None | $1,995.26 | $5,495.41 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $588.84 | Professional | None | $354.81 | $457.09 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $676.08 Typical High $891.25 | Professional | 50 · Both sides | $537.03 | $676.08 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $223.87 Median $288.40 Typical High $426.58 | Professional | 62 · Two surgeons | $223.87 | $288.40 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $72.44 Typical High $93.33 | Professional | 80 · Assistant surgeon | $57.54 | $72.44 | $93.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $63.10 Typical High $83.18 | Professional | AS · PA/NP assist | $50.12 | $63.10 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $630.96 Typical High $4,786.30 | Facility | None | $389.05 | $630.96 | $4,786.30 |
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 $691.83 Median $3,311.31 Typical High $3,715.35 | Facility | None | $691.83 | $3,311.31 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $2,454.71 | Professional | None | $407.38 | $602.56 | $2,454.71 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $758.58 | Professional | None | $416.87 | $549.54 | $758.58 |
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 $234.42 | Professional | 52 · Reduced service | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 54 · Surgery only | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $46.77 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $331.13 |
Where Kentucky sits
The same service costs 9.5 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
$490
OK $3,236UT $339
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.