How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,000 to $8,710Professionalmedian $871 · 10th to 90th $603 to $3,090
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 $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $2,511.89 | Professional | None | $537.03 | $676.08 | $2,511.89 |
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 $630.96 Median $912.01 Typical High $1,174.90 | Professional | None | $630.96 | $912.01 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $575.44 Typical High $741.31 | Professional | 62 · Two surgeons | $398.11 | $575.44 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $154.88 Typical High $190.55 | Professional | 80 · Assistant surgeon | $100.00 | $154.88 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $128.82 Typical High $165.96 | Professional | AS · PA/NP assist | $89.13 | $128.82 | $165.96 |
BCBS Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $831.76 | Professional | None | $537.03 | $588.84 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,691.53 Typical High $3,311.31 | Facility | None | $707.95 | $2,691.53 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,318.26 | Professional | None | $588.84 | $676.08 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,884.03 Typical High $10,964.78 | Facility | None | $54.95 | $2,884.03 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,318.26 Typical High $5,128.61 | Professional | None | $707.95 | $1,318.26 | $5,128.61 |
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 $616.60 Median $891.25 Typical High $1,548.82 | Professional | None | $616.60 | $891.25 | $1,548.82 |
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 $269.15 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $134.90 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $501.19 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $100.00 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $67.61 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $467.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $371.54 | $467.74 | $478.63 |
Where Missouri sits
The same service costs 9.8 times more in Oklahoma than in Utah. 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· 19th of 51
$1,096
OK $4,365UT $447
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.