How much rates vary
Facilitymedian $3,467 · 10th to 90th $724 to $9,550Professionalmedian $1,000 · 10th to 90th $759 to $3,388
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 $630.96 Median $758.58 Typical High $2,041.74 | Professional | None | $630.96 | $758.58 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $12,882.50 | Facility | None | $1,513.56 | $4,466.84 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,412.54 | Professional | None | $812.83 | $1,000.00 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $630.96 Typical High $891.25 | Professional | 62 · Two surgeons | $501.19 | $630.96 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $158.49 Typical High $223.87 | Professional | 80 · Assistant surgeon | $128.82 | $158.49 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $138.04 Typical High $199.53 | Professional | AS · PA/NP assist | $114.82 | $138.04 | $199.53 |
BCBS Kansas City Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,148.15 | Professional | None | $741.31 | $831.76 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,778.28 | Professional | None | $776.25 | $933.25 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,137.96 Typical High $6,606.93 | Facility | None | $54.95 | $2,137.96 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,513.56 Typical High $5,888.44 | Professional | None | $758.58 | $1,513.56 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,467.37 | $7,943.28 |
United Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,548.82 | Professional | None | $724.44 | $977.24 | $1,548.82 |
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 $316.23 Median $380.19 Typical High $389.05 | Professional | 52 · Reduced service | $316.23 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $151.36 Typical High $154.88 | Professional | 53 · Discontinued | $125.89 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $77.62 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $524.81 | $537.03 |
Where Missouri sits
The same service costs 8.5 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· 29th of 51
$1,072
OK $3,162TX $372
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.