How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,072 to $7,762Professionalmedian $1,202 · 10th to 90th $832 to $2,512
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 $954.99 Typical High $1,348.96 | Professional | None | $758.58 | $954.99 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,659.59 | Professional | None | $870.96 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $758.58 Typical High $1,047.13 | Professional | 62 · Two surgeons | $537.03 | $758.58 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $194.98 Typical High $263.03 | Professional | 80 · Assistant surgeon | $138.04 | $194.98 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $169.82 Typical High $229.09 | Professional | AS · PA/NP assist | $120.23 | $169.82 | $229.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,148.15 | Professional | None | $758.58 | $831.76 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,862.09 | Professional | None | $831.76 | $954.99 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $2,089.30 Typical High $6,606.93 | Facility | None | $1,000.00 | $2,089.30 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $7,244.36 | Professional | None | $1,000.00 | $1,862.09 | $7,244.36 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $6,760.83 | Facility | None | $1,000.00 | $3,388.44 | $6,760.83 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $2,187.76 | Professional | None | $870.96 | $1,230.27 | $2,187.76 |
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 $467.74 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $151.36 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $707.95 Typical High $724.44 | Professional | 54 · Surgery only | $562.34 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $141.25 Typical High $144.54 | Professional | 55 · Aftercare only | $112.20 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $660.69 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $524.81 | $660.69 | $676.08 |
Where Missouri sits
The same service costs 6.2 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· 17th of 51
$1,445
OK $3,631UT $589
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.