How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,259 to $15,136Professionalmedian $2,692 · 10th to 90th $1,820 to $5,129
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 $5,623.41 Typical High $15,135.61 | Facility | None | $1,778.28 | $5,623.41 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,737.80 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $4,677.35 Typical High $19,498.45 | Facility | None | $1,479.11 | $4,677.35 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,951.21 Typical High $3,630.78 | Professional | None | $2,089.30 | $2,951.21 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $4,466.84 Typical High $5,495.41 | Professional | 50 · Both sides | $3,090.30 | $4,466.84 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,862.09 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,318.26 | $1,862.09 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $478.63 Typical High $575.44 | Professional | 80 · Assistant surgeon | $338.84 | $478.63 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $416.87 Typical High $512.86 | Professional | AS · PA/NP assist | $288.40 | $416.87 | $512.86 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,778.28 | $1,949.84 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,089.30 Typical High $13,803.84 | Facility | None | $501.19 | $2,089.30 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $4,570.88 | Professional | None | $1,905.46 | $2,290.87 | $4,570.88 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $4,073.80 Typical High $10,715.19 | Facility | None | $1,513.56 | $4,073.80 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $1,949.84 Median $3,890.45 Typical High $25,703.96 | Professional | None | $1,949.84 | $3,890.45 | $25,703.96 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,513.56 | $3,981.07 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $3,981.07 | Professional | None | $1,819.70 | $2,691.53 | $3,981.07 |
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 $741.31 Median $870.96 Typical High $977.24 | Professional | 52 · Reduced service | $741.31 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $346.74 Typical High $389.05 | Professional | 53 · Discontinued | $295.12 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,318.26 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,122.02 | $1,318.26 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $263.03 Typical High $288.40 | Professional | 55 · Aftercare only | $223.87 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $173.78 Typical High $194.98 | Professional | 56 · Pre-op care only | $147.91 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,230.27 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,230.27 | $1,348.96 |
Where Missouri sits
The same service costs 8.5 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· 18th of 51
$2,951
AK $8,128TX $955
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.