How much rates vary
Facilitymedian $2,399 · 10th to 90th $832 to $7,079Professionalmedian $3,236 · 10th to 90th $2,291 to $19,953
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 $2,290.87 Median $5,623.41 Typical High $10,715.19 | Facility | None | $2,290.87 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,754.23 | Professional | None | $1,995.26 | $2,344.23 | $2,754.23 |
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 $2,511.89 Median $3,467.37 Typical High $4,466.84 | Professional | None | $2,511.89 | $3,467.37 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $2,187.76 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,584.89 | $2,187.76 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $549.54 Typical High $707.95 | Professional | 80 · Assistant surgeon | $398.11 | $549.54 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $478.63 Typical High $616.60 | Professional | AS · PA/NP assist | $346.74 | $478.63 | $616.60 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,511.89 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $3,311.31 | Facility | None | $758.58 | $1,445.44 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $5,495.41 | Professional | None | $2,290.87 | $2,818.38 | $5,495.41 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $18,620.87 | Facility | None | $645.65 | $1,995.26 | $18,620.87 |
Medica Setting Professional Modifier None Typical Low $2,290.87 Median $5,128.61 Typical High $19,952.62 | Professional | None | $2,290.87 | $5,128.61 | $19,952.62 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $3,235.94 Typical High $5,248.07 | Professional | None | $2,137.96 | $3,235.94 | $5,248.07 |
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 $1,000.00 Median $1,174.90 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,000.00 | $1,174.90 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $467.74 Typical High $512.86 | Professional | 53 · Discontinued | $398.11 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,737.80 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,479.11 | $1,737.80 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $354.81 Typical High $389.05 | Professional | 55 · Aftercare only | $295.12 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $234.42 Typical High $257.04 | Professional | 56 · Pre-op care only | $199.53 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,621.81 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,621.81 | $1,819.70 |
Where Missouri sits
The same service costs 15.8 times more in Alaska 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· 19th of 51
$3,162
AK $8,128TX $513
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.