How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,202 to $9,333Professionalmedian $1,175 · 10th to 90th $832 to $3,311
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 $831.76 Median $954.99 Typical High $1,862.09 | Professional | None | $831.76 | $954.99 | $1,862.09 |
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 $912.01 Median $1,288.25 Typical High $1,737.80 | Professional | None | $912.01 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $812.83 Typical High $1,047.13 | Professional | 62 · Two surgeons | $575.44 | $812.83 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $208.93 Typical High $275.42 | Professional | 80 · Assistant surgeon | $144.54 | $208.93 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $181.97 Typical High $245.47 | Professional | AS · PA/NP assist | $125.89 | $181.97 | $245.47 |
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 $645.65 Median $2,137.96 Typical High $2,691.53 | Facility | None | $645.65 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,862.09 | Professional | None | $812.83 | $977.24 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $3,715.35 Typical High $26,302.68 | Facility | None | $1,071.52 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $2,137.96 Typical High $7,762.47 | Professional | None | $912.01 | $2,137.96 | $7,762.47 |
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 $851.14 Median $1,174.90 Typical High $2,290.87 | Professional | None | $851.14 | $1,174.90 | $2,290.87 |
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 $416.87 Median $467.74 Typical High $512.86 | Professional | 52 · Reduced service | $416.87 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $186.21 Typical High $204.17 | Professional | 53 · Discontinued | $165.96 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $707.95 Typical High $776.25 | Professional | 54 · Surgery only | $616.60 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $141.25 Typical High $154.88 | Professional | 55 · Aftercare only | $123.03 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $93.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $83.18 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $660.69 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $575.44 | $660.69 | $724.44 |
Where Missouri sits
The same service costs 6.6 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· 20th of 51
$1,318
OK $3,802UT $575
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.