How much rates vary
Facilitymedian $2,754 · 10th to 90th $676 to $8,913Professionalmedian $589 · 10th to 90th $479 to $977
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 $549.54 Median $562.34 Typical High $3,235.94 | Facility | None | $549.54 | $562.34 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $812.83 | Professional | None | $549.54 | $549.54 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $9,332.54 | Facility | None | $1,071.52 | $3,311.31 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $831.76 | Professional | None | $478.63 | $588.84 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $371.54 Typical High $512.86 | Professional | 62 · Two surgeons | $302.00 | $371.54 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $93.33 Typical High $131.83 | Professional | 80 · Assistant surgeon | $77.62 | $93.33 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $81.28 Typical High $114.82 | Professional | AS · PA/NP assist | $67.61 | $81.28 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $870.96 Typical High $4,786.30 | Facility | None | $467.74 | $870.96 | $4,786.30 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $912.01 | Professional | None | $602.56 | $776.25 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $3,630.78 | Facility | None | $691.83 | $2,290.87 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $3,548.13 | Professional | None | $562.34 | $812.83 | $3,548.13 |
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 $489.78 Median $645.65 Typical High $1,047.13 | Professional | None | $489.78 | $645.65 | $1,047.13 |
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 $275.42 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $426.58 |
Where Kentucky sits
The same service costs 8.1 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· 47th of 51
$646
OK $3,467UT $427
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.