How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,000 to $13,804Professionalmedian $1,175 · 10th to 90th $933 to $1,820
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 $1,000.00 Median $1,122.02 Typical High $8,511.38 | Facility | None | $1,000.00 | $1,122.02 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,318.26 | Professional | None | $977.24 | $1,071.52 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $10,000.00 Typical High $14,454.40 | Facility | None | $1,995.26 | $10,000.00 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,584.89 | Professional | None | $933.25 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $741.31 Typical High $1,000.00 | Professional | 62 · Two surgeons | $588.84 | $741.31 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $190.55 Typical High $251.19 | Professional | 80 · Assistant surgeon | $147.91 | $190.55 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $165.96 Typical High $218.78 | Professional | AS · PA/NP assist | $131.83 | $165.96 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $1,659.59 Typical High $8,317.64 | Facility | None | $891.25 | $1,659.59 | $8,317.64 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,445.44 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $2,290.87 Typical High $6,165.95 | Facility | None | $34.67 | $2,290.87 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $6,918.31 | Professional | None | $1,071.52 | $1,584.89 | $6,918.31 |
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 $1,047.13 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,584.89 | $2,137.96 |
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 $489.78 Median $537.03 Typical High $645.65 | Professional | 52 · Reduced service | $489.78 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $263.03 | Professional | 53 · Discontinued | $199.53 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $977.24 | Professional | 54 · Surgery only | $741.31 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $194.98 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $107.15 Typical High $128.82 | Professional | 56 · Pre-op care only | $97.72 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $912.01 |
Where Kentucky sits
The same service costs 8.7 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· 44th of 51
$1,288
OK $6,166TX $708
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.