How much rates vary
Facilitymedian $1,585 · 10th to 90th $631 to $9,333Professionalmedian $575 · 10th to 90th $479 to $1,072
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 $630.96 Median $707.95 Typical High $2,630.27 | Facility | None | $630.96 | $707.95 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $776.25 | Professional | None | $616.60 | $676.08 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $13,489.63 | Facility | None | $5,011.87 | $8,317.64 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $891.25 | Professional | None | $478.63 | $562.34 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $354.81 Typical High $549.54 | Professional | 62 · Two surgeons | $302.00 | $354.81 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $91.20 Typical High $131.83 | Professional | 80 · Assistant surgeon | $77.62 | $91.20 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $79.43 Typical High $123.03 | Professional | AS · PA/NP assist | $67.61 | $79.43 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $2,754.23 | Facility | None | $630.96 | $1,548.82 | $2,754.23 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,071.52 | Professional | None | $660.69 | $912.01 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,096.48 | Facility | None | $34.67 | $512.86 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $3,981.07 | Professional | None | $676.08 | $933.25 | $3,981.07 |
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 $630.96 Median $977.24 Typical High $1,318.26 | Professional | None | $630.96 | $977.24 | $1,318.26 |
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 $309.03 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $309.03 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $154.88 | Professional | 53 · Discontinued | $125.89 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $537.03 |
Where Kentucky sits
The same service costs 6.9 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· 48th of 51
$617
OK $3,020TX $437
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.