How much rates vary
Facilitymedian $3,162 · 10th to 90th $933 to $7,762Professionalmedian $832 · 10th to 90th $603 to $1,950
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 $741.31 Median $4,897.79 Typical High $7,762.47 | Facility | None | $741.31 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $912.01 | Professional | None | $549.54 | $645.65 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $660.69 Median $831.76 Typical High $1,122.02 | Professional | None | $660.69 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,258.93 Typical High $1,659.59 | Professional | 50 · Both sides | $1,000.00 | $1,258.93 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $524.81 Typical High $707.95 | Professional | 62 · Two surgeons | $416.87 | $524.81 | $707.95 |
BCBS Kansas City Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $870.96 | Professional | None | $602.56 | $645.65 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,089.30 Typical High $2,691.53 | Facility | None | $707.95 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,348.96 | Professional | None | $537.03 | $707.95 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,019.95 Typical High $7,585.78 | Facility | None | $54.95 | $3,019.95 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,148.15 Typical High $4,786.30 | Professional | None | $676.08 | $1,148.15 | $4,786.30 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $12,302.69 | Facility | None | $977.24 | $4,570.88 | $12,302.69 |
United Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,288.25 | Professional | None | $588.84 | $851.14 | $1,288.25 |
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 $323.59 Typical High $363.08 | Professional | 52 · Reduced service | $275.42 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $128.82 Typical High $144.54 | Professional | 53 · Discontinued | $109.65 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $407.38 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $81.28 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $64.57 Typical High $72.44 | Professional | 56 · Pre-op care only | $54.95 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $380.19 | $457.09 | $501.19 |
Where Missouri sits
The same service costs 7.6 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.
Physician feeFacility fee
OK $11,248TX $1,472
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.