How much rates vary
Facilitymedian $1,122 · 10th to 90th $372 to $5,248Professionalmedian $347 · 10th to 90th $263 to $603
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 $331.13 Median $371.54 Typical High $5,248.07 | Facility | None | $331.13 | $371.54 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $416.87 | Professional | None | $323.59 | $354.81 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $11,220.18 | Facility | None | $758.58 | $5,011.87 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $478.63 | Professional | None | $257.04 | $309.03 | $478.63 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $162.18 Median $194.98 Typical High $295.12 | Professional | 62 · Two surgeons | $162.18 | $194.98 | $295.12 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $48.98 Typical High $75.86 | Professional | 80 · Assistant surgeon | $40.74 | $48.98 | $75.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $43.65 Typical High $67.61 | Professional | AS · PA/NP assist | $35.48 | $43.65 | $67.61 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $549.54 Typical High $2,818.38 | Facility | None | $331.13 | $549.54 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $562.34 | Professional | None | $338.84 | $478.63 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $2,137.96 | Facility | None | $588.84 | $1,862.09 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $2,187.76 | Professional | None | $354.81 | $501.19 | $2,187.76 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $691.83 | Professional | None | $331.13 | $501.19 | $691.83 |
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 $162.18 Median $177.83 Typical High $208.93 | Professional | 52 · Reduced service | $162.18 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $83.18 | Professional | 53 · Discontinued | $64.57 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 54 · Surgery only | $245.47 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $61.66 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $41.69 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $288.40 |
Where Kentucky sits
The same service costs 7.1 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· 49th of 51
$355
OK $1,950UT $275
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.