How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $13,183Professionalmedian $776 · 10th to 90th $575 to $2,138
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 $1,778.28 Median $5,754.40 Typical High $10,715.19 | Facility | None | $1,778.28 | $5,754.40 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $2,511.89 | Professional | None | $512.86 | $602.56 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,096.48 | Professional | None | $602.56 | $794.33 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $501.19 Typical High $691.83 | Professional | 62 · Two surgeons | $380.19 | $501.19 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $128.82 Typical High $177.83 | Professional | 80 · Assistant surgeon | $97.72 | $128.82 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $112.20 Typical High $154.88 | Professional | AS · PA/NP assist | $85.11 | $112.20 | $154.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $812.83 | Professional | None | $524.81 | $588.84 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,311.31 Typical High $12,589.25 | Facility | None | $851.14 | $3,311.31 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $1,348.96 | Professional | None | $562.34 | $660.69 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $5,011.87 Typical High $26,302.68 | Facility | None | $831.76 | $5,011.87 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,096.48 Typical High $4,786.30 | Professional | None | $602.56 | $1,096.48 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $13,182.57 | Facility | None | $1,023.29 | $4,570.88 | $13,182.57 |
United Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,174.90 | Professional | None | $562.34 | $707.95 | $1,174.90 |
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 $257.04 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $120.23 Typical High $123.03 | Professional | 53 · Discontinued | $104.71 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $446.68 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $60.26 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $416.87 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $416.87 | $426.58 |
Where Missouri sits
The same service costs 8.1 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· 30th of 51
$851
OK $3,467UT $427
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.