How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,148 to $9,550Professionalmedian $692 · 10th to 90th $501 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 $501.19 Median $575.44 Typical High $912.01 | Professional | None | $501.19 | $575.44 | $912.01 |
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 $512.86 Median $741.31 Typical High $1,000.00 | Professional | None | $512.86 | $741.31 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,096.48 Typical High $1,513.56 | Professional | 50 · Both sides | $776.25 | $1,096.48 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $117.49 Typical High $158.49 | Professional | 80 · Assistant surgeon | $83.18 | $117.49 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $104.71 Typical High $141.25 | Professional | AS · PA/NP assist | $72.44 | $104.71 | $141.25 |
BCBS Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $707.95 | Professional | None | $457.09 | $501.19 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,238.72 Typical High $3,311.31 | Facility | None | $758.58 | $2,238.72 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $1,122.02 | Professional | None | $489.78 | $562.34 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $26,302.68 | Facility | None | $758.58 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,258.93 Typical High $4,168.69 | Professional | None | $549.54 | $1,258.93 | $4,168.69 |
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 $512.86 Median $707.95 Typical High $1,380.38 | Professional | None | $512.86 | $707.95 | $1,380.38 |
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 $251.19 Median $281.84 Typical High $309.03 | Professional | 52 · Reduced service | $251.19 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $123.03 | Professional | 53 · Discontinued | $100.00 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $371.54 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $61.66 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $346.74 | $398.11 | $436.52 |
Where Missouri sits
The same service costs 10.0 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· 25th of 51
$759
OK $3,631UT $363
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.