How much rates vary
Facilitymedian $2,188 · 10th to 90th $813 to $9,772Professionalmedian $724 · 10th to 90th $562 to $1,445
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 $794.33 Median $831.76 Typical High $2,630.27 | Facility | None | $794.33 | $831.76 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $954.99 | Professional | None | $776.25 | $812.83 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $794.33 | Professional | None | $549.54 | $645.65 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $977.24 Typical High $1,202.26 | Professional | 50 · Both sides | $812.83 | $977.24 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $102.33 Typical High $123.03 | Professional | 80 · Assistant surgeon | $87.10 | $102.33 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $91.20 Typical High $109.65 | Professional | AS · PA/NP assist | $75.86 | $91.20 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $2,041.74 | Facility | None | $602.56 | $1,122.02 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,174.90 | Professional | None | $691.83 | $977.24 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,174.90 Typical High $1,548.82 | Facility | None | $34.67 | $1,174.90 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $3,311.31 | Professional | None | $724.44 | $1,047.13 | $3,311.31 |
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 $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 $676.08 Median $812.83 Typical High $1,318.26 | Professional | None | $676.08 | $812.83 | $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 $389.05 Median $407.38 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $158.49 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $562.34 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $562.34 | $660.69 |
Where Kentucky sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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.
Physician feeFacility fee
OK $7,181MS $1,948
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.