How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,259 to $10,965Professionalmedian $1,122 · 10th to 90th $794 to $2,399
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 $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,318.26 | Professional | None | $758.58 | $831.76 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,380.38 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,548.82 | Professional | None | $794.33 | $1,122.02 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,659.59 Typical High $2,344.23 | Professional | 50 · Both sides | $1,202.26 | $1,659.59 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $707.95 Typical High $977.24 | Professional | 62 · Two surgeons | $501.19 | $707.95 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $177.83 Typical High $251.19 | Professional | 80 · Assistant surgeon | $128.82 | $177.83 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $154.88 Typical High $218.78 | Professional | AS · PA/NP assist | $112.20 | $154.88 | $218.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,148.15 | Professional | None | $758.58 | $812.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,311.31 Typical High $4,365.16 | Facility | None | $758.58 | $3,311.31 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,862.09 | Professional | None | $758.58 | $891.25 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,000.00 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,621.81 Typical High $6,165.95 | Professional | None | $851.14 | $1,621.81 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,778.28 | Professional | None | $831.76 | $1,122.02 | $1,778.28 |
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 $380.19 Median $416.87 Typical High $426.58 | Professional | 52 · Reduced service | $380.19 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $169.82 | Professional | 53 · Discontinued | $154.88 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $575.44 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $128.82 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $602.56 |
Where Missouri sits
The same service costs 7.4 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.
Missouri· 27th of 51
$1,148
OK $3,890TX $525
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.