How much rates vary
Facilitymedian $2,042 · 10th to 90th $646 to $6,457Professionalmedian $1,023 · 10th to 90th $759 to $2,754
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 $676.08 Median $794.33 Typical High $1,000.00 | Professional | None | $676.08 | $794.33 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,445.44 | Professional | None | $776.25 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $660.69 Typical High $912.01 | Professional | 62 · Two surgeons | $489.78 | $660.69 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $165.96 Typical High $229.09 | Professional | 80 · Assistant surgeon | $125.89 | $165.96 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $147.91 Typical High $199.53 | Professional | AS · PA/NP assist | $109.65 | $147.91 | $199.53 |
BCBS Kansas City Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,096.48 | Professional | None | $831.76 | $891.25 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $2,691.53 | Facility | None | $645.65 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,862.09 | Professional | None | $758.58 | $933.25 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $26,302.68 | Facility | None | $1,000.00 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,737.80 Typical High $6,760.83 | Professional | None | $794.33 | $1,737.80 | $6,760.83 |
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 $758.58 Median $1,096.48 Typical High $1,737.80 | Professional | None | $758.58 | $1,096.48 | $1,737.80 |
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 $338.84 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $338.84 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $134.90 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $602.56 Typical High $660.69 | Professional | 54 · Surgery only | $501.19 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $100.00 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $562.34 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $467.74 | $562.34 | $616.60 |
Where Missouri sits
The same service costs 7.6 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· 24th of 51
$1,096
AK $3,715TX $490
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.