How much rates vary
Facilitymedian $1,122 · 10th to 90th $145 to $3,715Professionalmedian $339 · 10th to 90th $229 to $1,950
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 $389.05 Median $3,162.28 Typical High $7,762.47 | Facility | None | $389.05 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $467.74 | Professional | None | $218.78 | $316.23 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $416.87 | Professional | None | $229.09 | $269.15 | $416.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $42.66 Typical High $66.07 | Professional | 80 · Assistant surgeon | $37.15 | $42.66 | $66.07 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $37.15 Typical High $57.54 | Professional | AS · PA/NP assist | $32.36 | $37.15 | $57.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $478.63 | Professional | None | $251.19 | $380.19 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $309.03 Typical High $562.34 | Facility | None | $66.07 | $309.03 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $602.56 | Professional | None | $245.47 | $371.54 | $602.56 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $758.58 Typical High $1,995.26 | Facility | None | $54.95 | $758.58 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $1,949.84 Typical High $2,754.23 | Professional | None | $371.54 | $1,949.84 | $2,754.23 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $588.84 | Professional | None | $263.03 | $389.05 | $588.84 |
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 $109.65 Median $158.49 Typical High $194.98 | Professional | 52 · Reduced service | $109.65 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $63.10 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $234.42 Typical High $295.12 | Professional | 54 · Surgery only | $165.96 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $46.77 Typical High $58.88 | Professional | 55 · Aftercare only | $33.11 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $31.62 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $218.78 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $154.88 | $218.78 | $275.42 |
Where Missouri sits
The same service costs 4.5 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· 34th of 51
$363
AK $1,072TX $240
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.