How much rates vary
Facilitymedian $3,236 · 10th to 90th $891 to $7,079Professionalmedian $1,047 · 10th to 90th $741 to $2,188
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 $851.14 Median $4,897.79 Typical High $7,762.47 | Facility | None | $851.14 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $912.01 | Professional | None | $588.84 | $724.44 | $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 $812.83 Median $1,071.52 Typical High $1,479.11 | Professional | None | $812.83 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $676.08 Typical High $933.25 | Professional | 62 · Two surgeons | $512.86 | $676.08 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $173.78 Typical High $234.42 | Professional | 80 · Assistant surgeon | $128.82 | $173.78 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $151.36 Typical High $204.17 | Professional | AS · PA/NP assist | $112.20 | $151.36 | $204.17 |
BCBS Kansas City Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,071.52 | Professional | None | $691.83 | $758.58 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,162.28 Typical High $4,677.35 | Facility | None | $707.95 | $3,162.28 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,737.80 | Professional | None | $724.44 | $891.25 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,290.87 Typical High $16,218.10 | Facility | None | $54.95 | $2,290.87 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,905.46 Typical High $5,754.40 | Professional | None | $794.33 | $1,905.46 | $5,754.40 |
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 $776.25 Median $1,071.52 Typical High $1,995.26 | Professional | None | $776.25 | $1,071.52 | $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 $295.12 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $295.12 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $117.49 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $549.54 Typical High $562.34 | Professional | 54 · Surgery only | $436.52 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $109.65 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $58.88 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $512.86 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $407.38 | $512.86 | $524.81 |
Where Missouri sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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· 22nd of 51
$1,175
OK $3,548TX $525
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.