How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,096 to $9,550Professionalmedian $3,311 · 10th to 90th $2,455 to $7,413
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 $5,623.41 Typical High $10,715.19 | Facility | None | $2,290.87 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $2,951.21 | Professional | None | $2,238.72 | $2,630.27 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $3,311.31 Typical High $4,365.16 | Professional | None | $2,754.23 | $3,311.31 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,698.24 Median $2,089.30 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,698.24 | $2,089.30 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $537.03 Typical High $707.95 | Professional | 80 · Assistant surgeon | $436.52 | $537.03 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $467.74 Typical High $616.60 | Professional | AS · PA/NP assist | $380.19 | $467.74 | $616.60 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,344.23 Median $2,570.40 Typical High $3,467.37 | Professional | None | $2,344.23 | $2,570.40 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,888.44 Typical High $8,511.38 | Facility | None | $707.95 | $5,888.44 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $5,495.41 | Professional | None | $2,187.76 | $2,884.03 | $5,495.41 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,715.35 Typical High $15,488.17 | Facility | None | $54.95 | $3,715.35 | $15,488.17 |
Medica Setting Professional Modifier None Typical Low $2,691.53 Median $4,466.84 Typical High $19,054.61 | Professional | None | $2,691.53 | $4,466.84 | $19,054.61 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $5,248.07 | Professional | None | $2,344.23 | $3,388.44 | $5,248.07 |
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 $1,122.02 Median $1,318.26 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,122.02 | $1,318.26 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $524.81 Typical High $588.84 | Professional | 53 · Discontinued | $446.68 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,995.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,659.59 | $1,995.26 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $398.11 Typical High $436.52 | Professional | 55 · Aftercare only | $331.13 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $263.03 Typical High $295.12 | Professional | 56 · Pre-op care only | $223.87 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,862.09 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,862.09 | $2,041.74 |
Where Missouri sits
The same service costs 8.7 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· 28th of 51
$3,311
AK $10,715TX $1,230
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.