How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,122 to $15,136Professionalmedian $5,012 · 10th to 90th $3,631 to $16,982
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 $3,311.31 Median $3,981.07 Typical High $4,365.16 | Professional | None | $3,311.31 | $3,981.07 | $4,365.16 |
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 $4,073.80 Median $5,011.87 Typical High $7,079.46 | Professional | None | $4,073.80 | $5,011.87 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $6,165.95 Median $7,585.78 Typical High $10,715.19 | Professional | 50 · Both sides | $6,165.95 | $7,585.78 | $10,715.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,570.40 Median $3,162.28 Typical High $4,466.84 | Professional | 62 · Two surgeons | $2,570.40 | $3,162.28 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $660.69 Median $794.33 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $660.69 | $794.33 | $1,122.02 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $575.44 Median $707.95 Typical High $1,000.00 | Professional | AS · PA/NP assist | $575.44 | $707.95 | $1,000.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $3,548.13 Median $3,801.89 Typical High $5,128.61 | Professional | None | $3,548.13 | $3,801.89 | $5,128.61 |
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 $3,235.94 Median $4,365.16 Typical High $8,128.31 | Professional | None | $3,235.94 | $4,365.16 | $8,128.31 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $5,011.87 Typical High $25,118.86 | Facility | None | $54.95 | $5,011.87 | $25,118.86 |
Medica Setting Professional Modifier None Typical Low $4,073.80 Median $6,760.83 Typical High $30,199.52 | Professional | None | $4,073.80 | $6,760.83 | $30,199.52 |
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 $3,548.13 Median $5,128.61 Typical High $7,762.47 | Professional | None | $3,548.13 | $5,128.61 | $7,762.47 |
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 $1,659.59 Median $1,949.84 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,659.59 | $1,949.84 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $794.33 Typical High $870.96 | Professional | 53 · Discontinued | $660.69 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,951.21 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,454.71 | $2,951.21 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $588.84 Typical High $660.69 | Professional | 55 · Aftercare only | $501.19 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $398.11 Typical High $436.52 | Professional | 56 · Pre-op care only | $331.13 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,754.23 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,754.23 | $3,019.95 |
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· 29th of 51
$4,898
AK $15,849TX $776
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.