How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,230 to $10,471Professionalmedian $1,413 · 10th to 90th $977 to $3,467
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 $954.99 Median $1,096.48 Typical High $1,949.84 | Professional | None | $954.99 | $1,096.48 | $1,949.84 |
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 $1,047.13 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,584.89 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $1,000.00 Typical High $1,318.26 | Professional | 62 · Two surgeons | $660.69 | $1,000.00 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $251.19 Typical High $338.84 | Professional | 80 · Assistant surgeon | $165.96 | $251.19 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $218.78 Typical High $295.12 | Professional | AS · PA/NP assist | $147.91 | $218.78 | $295.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,318.26 | Professional | None | $870.96 | $954.99 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,897.79 Typical High $7,244.36 | Facility | None | $645.65 | $4,897.79 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $2,187.76 | Professional | None | $954.99 | $1,148.15 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $3,715.35 Typical High $26,915.35 | Facility | None | $1,096.48 | $3,715.35 | $26,915.35 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $2,454.71 Typical High $7,079.46 | Professional | None | $1,071.52 | $2,454.71 | $7,079.46 |
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 $977.24 Median $1,380.38 Typical High $2,630.27 | Professional | None | $977.24 | $1,380.38 | $2,630.27 |
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 $478.63 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $478.63 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $190.55 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $144.54 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $95.50 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $831.76 |
Where Missouri sits
The same service costs 6.3 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· 14th of 51
$1,778
OK $4,169UT $661
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.