How much rates vary
Facilitymedian $1,202 · 10th to 90th $692 to $5,370Professionalmedian $813 · 10th to 90th $617 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 $776.25 Typical High $891.25 | Facility | None | $691.83 | $776.25 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $891.25 | Professional | None | $676.08 | $741.31 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $11,220.18 | Facility | None | $758.58 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,071.52 | Professional | None | $616.60 | $812.83 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $512.86 Typical High $676.08 | Professional | 62 · Two surgeons | $389.05 | $512.86 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $128.82 Typical High $173.78 | Professional | 80 · Assistant surgeon | $100.00 | $128.82 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $112.20 Typical High $151.36 | Professional | AS · PA/NP assist | $87.10 | $112.20 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,778.28 | Facility | None | $691.83 | $1,071.52 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,174.90 | Professional | None | $707.95 | $1,000.00 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,230.27 Typical High $3,890.45 | Facility | None | $34.67 | $1,230.27 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $4,570.88 | Professional | None | $724.44 | $1,047.13 | $4,570.88 |
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 $707.95 Median $1,071.52 Typical High $1,412.54 | Professional | None | $707.95 | $1,071.52 | $1,412.54 |
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 $338.84 Median $371.54 Typical High $436.52 | Professional | 52 · Reduced service | $338.84 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $147.91 Typical High $177.83 | Professional | 53 · Discontinued | $134.90 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $501.19 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $131.83 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $74.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $67.61 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $467.74 | $512.86 | $616.60 |
Where Kentucky sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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· 45th of 51
$813
OK $3,548TX $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.