How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,122 to $15,136Professionalmedian $3,162 · 10th to 90th $2,512 to $11,220
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 $4,897.79 Typical High $7,762.47 | Facility | None | $2,290.87 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,019.95 | Professional | None | $2,290.87 | $2,754.23 | $3,019.95 |
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 $2,691.53 Median $3,235.94 Typical High $4,677.35 | Professional | None | $2,691.53 | $3,235.94 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $4,897.79 Typical High $7,079.46 | Professional | 50 · Both sides | $3,981.07 | $4,897.79 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,698.24 Median $2,041.74 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,698.24 | $2,041.74 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $524.81 Typical High $741.31 | Professional | 80 · Assistant surgeon | $426.58 | $524.81 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $457.09 Typical High $660.69 | Professional | AS · PA/NP assist | $371.54 | $457.09 | $660.69 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,454.71 Median $2,630.27 Typical High $3,467.37 | Professional | None | $2,454.71 | $2,630.27 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $13,803.84 Typical High $19,952.62 | Facility | None | $707.95 | $13,803.84 | $19,952.62 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $5,128.61 | Professional | None | $2,290.87 | $3,019.95 | $5,128.61 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $4,073.80 Typical High $19,054.61 | Facility | None | $54.95 | $4,073.80 | $19,054.61 |
Medica Setting Professional Modifier None Typical Low $2,570.40 Median $4,570.88 Typical High $20,417.38 | Professional | None | $2,570.40 | $4,570.88 | $20,417.38 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $19,054.61 | Facility | None | $1,174.90 | $5,248.07 | $19,054.61 |
United Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $5,370.32 | Professional | None | $2,454.71 | $3,235.94 | $5,370.32 |
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 $1,148.15 Median $1,380.38 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,148.15 | $1,380.38 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $549.54 Typical High $602.56 | Professional | 53 · Discontinued | $457.09 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,041.74 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,737.80 | $2,041.74 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $416.87 Typical High $457.09 | Professional | 55 · Aftercare only | $346.74 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $275.42 Typical High $302.00 | Professional | 56 · Pre-op care only | $229.09 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,905.46 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,905.46 | $2,137.96 |
Where Missouri sits
The same service costs 20.0 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· 30th of 51
$3,236
AK $11,220TX $562
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.