How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,148 to $9,333Professionalmedian $794 · 10th to 90th $575 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 $1,698.24 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,288.25 | Professional | None | $562.34 | $645.65 | $1,288.25 |
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 $588.84 Median $812.83 Typical High $1,096.48 | Professional | None | $588.84 | $812.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $512.86 Typical High $691.83 | Professional | 62 · Two surgeons | $371.54 | $512.86 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $128.82 Typical High $173.78 | Professional | 80 · Assistant surgeon | $95.50 | $128.82 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $112.20 Typical High $151.36 | Professional | AS · PA/NP assist | $83.18 | $112.20 | $151.36 |
BCBS Kansas City Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $891.25 | Professional | None | $707.95 | $707.95 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $3,311.31 | Facility | None | $758.58 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,288.25 | Professional | None | $549.54 | $645.65 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $3,715.35 Typical High $26,302.68 | Facility | None | $794.33 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,348.96 Typical High $6,025.60 | Professional | None | $630.96 | $1,348.96 | $6,025.60 |
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 $602.56 Median $794.33 Typical High $1,778.28 | Professional | None | $602.56 | $794.33 | $1,778.28 |
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 $316.23 Typical High $346.74 | Professional | 52 · Reduced service | $281.84 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $128.82 Typical High $138.04 | Professional | 53 · Discontinued | $112.20 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $478.63 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $64.57 Typical High $69.18 | Professional | 56 · Pre-op care only | $56.23 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $446.68 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $398.11 | $446.68 | $489.78 |
Where Missouri sits
The same service costs 7.4 times more in Oklahoma than in New York. 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· 42nd of 51
$871
OK $3,802NY $513
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.