How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,122 to $15,136Professionalmedian $3,890 · 10th to 90th $3,020 to $13,804
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 $2,511.89 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,511.89 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,630.78 | Professional | None | $2,754.23 | $3,235.94 | $3,630.78 |
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 $3,311.31 Median $3,981.07 Typical High $5,754.40 | Professional | None | $3,311.31 | $3,981.07 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,897.79 Median $6,025.60 Typical High $8,511.38 | Professional | 50 · Both sides | $4,897.79 | $6,025.60 | $8,511.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,089.30 Median $2,511.89 Typical High $3,630.78 | Professional | 62 · Two surgeons | $2,089.30 | $2,511.89 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $630.96 Typical High $912.01 | Professional | 80 · Assistant surgeon | $524.81 | $630.96 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $562.34 Typical High $794.33 | Professional | AS · PA/NP assist | $457.09 | $562.34 | $794.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,951.21 Median $3,162.28 Typical High $4,073.80 | Professional | None | $2,951.21 | $3,162.28 | $4,073.80 |
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 $2,691.53 Median $3,548.13 Typical High $6,456.54 | Professional | None | $2,691.53 | $3,548.13 | $6,456.54 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $4,466.84 Typical High $21,379.62 | Facility | None | $54.95 | $4,466.84 | $21,379.62 |
Medica Setting Professional Modifier None Typical Low $3,162.28 Median $5,495.41 Typical High $26,915.35 | Professional | None | $3,162.28 | $5,495.41 | $26,915.35 |
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 $2,884.03 Median $3,890.45 Typical High $6,456.54 | Professional | None | $2,884.03 | $3,890.45 | $6,456.54 |
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 $1,380.38 Median $1,621.81 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,380.38 | $1,621.81 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $660.69 Typical High $724.44 | Professional | 53 · Discontinued | $549.54 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,454.71 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,041.74 | $2,454.71 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $489.78 Typical High $537.03 | Professional | 55 · Aftercare only | $407.38 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $323.59 Typical High $363.08 | Professional | 56 · Pre-op care only | $275.42 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,290.87 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,290.87 | $2,511.89 |
Where Missouri sits
The same service costs 20.4 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· 33rd of 51
$3,890
AK $13,183TX $646
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.