How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,122 to $10,471Professionalmedian $851 · 10th to 90th $617 to $1,820
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 $1,096.48 Median $3,715.35 Typical High $7,762.47 | Facility | None | $1,096.48 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,412.54 | Professional | None | $562.34 | $707.95 | $1,412.54 |
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 $645.65 Median $851.14 Typical High $1,174.90 | Professional | None | $645.65 | $851.14 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $537.03 Typical High $741.31 | Professional | 62 · Two surgeons | $398.11 | $537.03 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $138.04 Typical High $190.55 | Professional | 80 · Assistant surgeon | $102.33 | $138.04 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $120.23 Typical High $165.96 | Professional | AS · PA/NP assist | $89.13 | $120.23 | $165.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $870.96 | Professional | None | $562.34 | $616.60 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $3,890.45 | Facility | None | $602.56 | $2,691.53 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $1,380.38 | Professional | None | $616.60 | $691.83 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $3,715.35 Typical High $16,218.10 | Facility | None | $851.14 | $3,715.35 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,380.38 Typical High $4,677.35 | Professional | None | $741.31 | $1,380.38 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,621.81 | Professional | None | $645.65 | $912.01 | $1,621.81 |
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 $281.84 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $281.84 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $141.25 Typical High $144.54 | Professional | 53 · Discontinued | $112.20 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $524.81 Typical High $537.03 | Professional | 54 · Surgery only | $416.87 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $104.71 Typical High $107.15 | Professional | 55 · Aftercare only | $83.18 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $70.79 Typical High $72.44 | Professional | 56 · Pre-op care only | $56.23 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $489.78 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $389.05 | $489.78 | $501.19 |
Where Missouri sits
The same service costs 5.7 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 $10,813MT $1,910
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.