How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,202 to $9,550Professionalmedian $1,047 · 10th to 90th $813 to $2,239
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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,348.96 | Professional | None | $741.31 | $912.01 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,412.54 | Professional | None | $831.76 | $977.24 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $616.60 Typical High $870.96 | Professional | 62 · Two surgeons | $524.81 | $616.60 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $154.88 Typical High $223.87 | Professional | 80 · Assistant surgeon | $131.83 | $154.88 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $138.04 Typical High $194.98 | Professional | AS · PA/NP assist | $114.82 | $138.04 | $194.98 |
BCBS Kansas City Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,202.26 | Professional | None | $851.14 | $912.01 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $4,786.30 Typical High $6,606.93 | Facility | None | $1,584.89 | $4,786.30 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,778.28 | Professional | None | $741.31 | $933.25 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $16,982.44 | Facility | None | $1,000.00 | $3,467.37 | $16,982.44 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,445.44 Typical High $6,456.54 | Professional | None | $851.14 | $1,445.44 | $6,456.54 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,737.80 | Professional | None | $776.25 | $1,096.48 | $1,737.80 |
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 $371.54 Median $457.09 Typical High $489.78 | Professional | 52 · Reduced service | $371.54 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $181.97 Typical High $194.98 | Professional | 53 · Discontinued | $147.91 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $676.08 Typical High $724.44 | Professional | 54 · Surgery only | $549.54 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $109.65 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $91.20 Typical High $97.72 | Professional | 56 · Pre-op care only | $74.13 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $512.86 | $630.96 | $676.08 |
Where Missouri sits
The same service costs 5.1 times more in Oklahoma than in Kentucky. 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 $11,738KY $2,311
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.