How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,259 to $10,715Professionalmedian $1,023 · 10th to 90th $724 to $2,630
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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,659.59 | Professional | None | $724.44 | $831.76 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,479.11 | Professional | None | $794.33 | $1,023.29 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $630.96 Typical High $954.99 | Professional | 62 · Two surgeons | $501.19 | $630.96 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $162.18 Typical High $239.88 | Professional | 80 · Assistant surgeon | $125.89 | $162.18 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $141.25 Typical High $213.80 | Professional | AS · PA/NP assist | $109.65 | $141.25 | $213.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $1,000.00 | Professional | None | $660.69 | $724.44 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,691.53 Typical High $3,890.45 | Facility | None | $645.65 | $2,691.53 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,621.81 | Professional | None | $724.44 | $812.83 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $4,073.80 Typical High $26,302.68 | Facility | None | $1,023.29 | $4,073.80 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,862.09 Typical High $6,918.31 | Professional | None | $812.83 | $1,862.09 | $6,918.31 |
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 $741.31 Median $1,023.29 Typical High $1,995.26 | Professional | None | $741.31 | $1,023.29 | $1,995.26 |
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 $407.38 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $165.96 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $630.96 |
Where Missouri sits
The same service costs 8.7 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· 23rd of 51
$1,072
OK $4,365UT $501
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.