How much rates vary
Facilitymedian $2,344 · 10th to 90th $631 to $7,244Professionalmedian $933 · 10th to 90th $759 to $2,089
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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,288.25 | Professional | None | $724.44 | $912.01 | $1,288.25 |
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 $758.58 Median $891.25 Typical High $1,412.54 | Professional | None | $758.58 | $891.25 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $141.25 Typical High $229.09 | Professional | 80 · Assistant surgeon | $120.23 | $141.25 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $123.03 Typical High $199.53 | Professional | AS · PA/NP assist | $107.15 | $123.03 | $199.53 |
BCBS Kansas City Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,122.02 | Professional | None | $724.44 | $794.33 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,691.53 Typical High $3,890.45 | Facility | None | $446.68 | $2,691.53 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,778.28 | Professional | None | $776.25 | $891.25 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $3,801.89 Typical High $18,197.01 | Facility | None | $1,000.00 | $3,801.89 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,778.28 Typical High $5,888.44 | Professional | None | $954.99 | $1,778.28 | $5,888.44 |
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 $812.83 Median $1,174.90 Typical High $2,089.30 | Professional | None | $812.83 | $1,174.90 | $2,089.30 |
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 $363.08 Median $446.68 Typical High $467.74 | Professional | 52 · Reduced service | $363.08 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $181.97 Typical High $186.21 | Professional | 53 · Discontinued | $144.54 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $676.08 Typical High $691.83 | Professional | 54 · Surgery only | $537.03 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $134.90 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $89.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $72.44 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $630.96 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $501.19 | $630.96 | $645.65 |
Where Missouri sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $1,932
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.