How much rates vary
Facilitymedian $2,754 · 10th to 90th $851 to $7,079Professionalmedian $575 · 10th to 90th $398 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 $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 $331.13 Median $407.38 Typical High $616.60 | Professional | None | $331.13 | $407.38 | $616.60 |
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 $398.11 Median $616.60 Typical High $812.83 | Professional | None | $398.11 | $616.60 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $251.19 Median $380.19 Typical High $501.19 | Professional | 62 · Two surgeons | $251.19 | $380.19 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $97.72 Typical High $131.83 | Professional | 80 · Assistant surgeon | $64.57 | $97.72 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $81.28 Typical High $114.82 | Professional | AS · PA/NP assist | $56.23 | $81.28 | $114.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $588.84 | Professional | None | $380.19 | $426.58 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,137.96 Typical High $2,691.53 | Facility | None | $707.95 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $977.24 | Professional | None | $407.38 | $501.19 | $977.24 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,862.09 Typical High $9,549.93 | Facility | None | $54.95 | $1,862.09 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,071.52 Typical High $3,801.89 | Professional | None | $426.58 | $1,071.52 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $1,122.02 | Professional | None | $416.87 | $575.44 | $1,122.02 |
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 $165.96 Median $204.17 Typical High $208.93 | Professional | 52 · Reduced service | $165.96 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $81.28 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $309.03 Typical High $316.23 | Professional | 54 · Surgery only | $245.47 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $48.98 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $40.74 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $288.40 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $229.09 | $288.40 | $295.12 |
Where Missouri sits
The same service costs 10.2 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· 21st of 51
$708
OK $2,951UT $288
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.