How much rates vary
Facilitymedian $1,995 · 10th to 90th $355 to $7,586Professionalmedian $324 · 10th to 90th $263 to $537
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 $302.00 Median $338.84 Typical High $2,630.27 | Facility | None | $302.00 | $338.84 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $398.11 | Professional | None | $295.12 | $323.59 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $436.52 | Professional | None | $263.03 | $323.59 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $478.63 Typical High $660.69 | Professional | 50 · Both sides | $398.11 | $478.63 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $50.12 Typical High $66.07 | Professional | 80 · Assistant surgeon | $42.66 | $50.12 | $66.07 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $44.67 Typical High $61.66 | Professional | AS · PA/NP assist | $37.15 | $44.67 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $501.19 Typical High $2,818.38 | Facility | None | $302.00 | $501.19 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $512.86 | Professional | None | $281.84 | $436.52 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,862.09 Typical High $2,089.30 | Facility | None | $524.81 | $1,862.09 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $1,778.28 | Professional | None | $323.59 | $426.58 | $1,778.28 |
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 $281.84 Median $446.68 Typical High $602.56 | Professional | None | $281.84 | $446.68 | $602.56 |
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 $147.91 Median $162.18 Typical High $169.82 | Professional | 52 · Reduced service | $147.91 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $58.88 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $239.88 Typical High $257.04 | Professional | 54 · Surgery only | $218.78 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $51.29 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $33.88 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $223.87 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $204.17 | $223.87 | $239.88 |
Where Kentucky sits
The same service costs 11.7 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· 46th of 51
$347
OK $2,754UT $234
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.