How much rates vary
Facilitymedian $1,995 · 10th to 90th $562 to $5,888Professionalmedian $437 · 10th to 90th $295 to $1,660
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 $269.15 Median $338.84 Typical High $602.56 | Professional | None | $269.15 | $338.84 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $588.84 | Professional | None | $309.03 | $457.09 | $588.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $194.98 Median $288.40 Typical High $371.54 | Professional | 62 · Two surgeons | $194.98 | $288.40 | $371.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $74.13 Typical High $93.33 | Professional | 80 · Assistant surgeon | $50.12 | $74.13 | $93.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $66.07 Typical High $81.28 | Professional | AS · PA/NP assist | $43.65 | $66.07 | $81.28 |
BCBS Kansas City Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $426.58 | Professional | None | $275.42 | $302.00 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $3,311.31 | Facility | None | $758.58 | $1,318.26 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $660.69 | Professional | None | $288.40 | $380.19 | $660.69 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $26,302.68 | Facility | None | $645.65 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $645.65 Typical High $6,918.31 | Professional | None | $354.81 | $645.65 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $776.25 | Professional | None | $309.03 | $436.52 | $776.25 |
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 $134.90 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $134.90 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $67.61 Typical High $69.18 | Professional | 53 · Discontinued | $53.70 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $251.19 Typical High $257.04 | Professional | 54 · Surgery only | $199.53 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $50.12 Typical High $51.29 | Professional | 55 · Aftercare only | $39.81 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.11 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.92 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $234.42 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $186.21 | $234.42 | $239.88 |
Where Missouri sits
The same service costs 6.6 times more in Oklahoma than in Montana. 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 $6,126MT $925
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.