How much rates vary
Facilitymedian $2,754 · 10th to 90th $977 to $6,761Professionalmedian $851 · 10th to 90th $661 to $2,630
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 $812.83 Median $870.96 Typical High $1,202.26 | Professional | None | $812.83 | $870.96 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,288.25 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,412.54 | Professional | None | $588.84 | $812.83 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,230.27 Typical High $2,089.30 | Professional | 50 · Both sides | $891.25 | $1,230.27 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $131.83 Typical High $223.87 | Professional | 80 · Assistant surgeon | $95.50 | $131.83 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $114.82 Typical High $194.98 | Professional | AS · PA/NP assist | $83.18 | $114.82 | $194.98 |
BCBS Kansas City Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,000.00 | Professional | None | $676.08 | $724.44 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,621.81 Typical High $6,760.83 | Facility | None | $707.95 | $1,621.81 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,445.44 | Professional | None | $724.44 | $794.33 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,862.09 Typical High $6,918.31 | Facility | None | $54.95 | $1,862.09 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,258.93 Typical High $5,888.44 | Professional | None | $691.83 | $1,258.93 | $5,888.44 |
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 $691.83 Median $933.25 Typical High $1,445.44 | Professional | None | $691.83 | $933.25 | $1,445.44 |
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 $407.38 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $407.38 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $162.18 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $602.56 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $660.69 |
Where Missouri sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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.
Physician feeFacility fee
OK $7,181MS $1,948
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.