How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,096 to $7,943Professionalmedian $1,380 · 10th to 90th $1,072 to $3,890
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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,445.44 | Professional | None | $977.24 | $1,148.15 | $1,445.44 |
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 $1,174.90 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,380.38 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $870.96 Typical High $1,174.90 | Professional | 62 · Two surgeons | $741.31 | $870.96 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $302.00 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $263.03 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $263.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,096.48 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,951.21 Typical High $4,365.16 | Facility | None | $645.65 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $2,454.71 | Professional | None | $954.99 | $1,288.25 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,951.21 Typical High $13,803.84 | Facility | None | $54.95 | $2,951.21 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $10,000.00 | Professional | None | $1,230.27 | $1,995.26 | $10,000.00 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,548.82 | $2,344.23 |
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 $489.78 Median $575.44 Typical High $645.65 | Professional | 52 · Reduced service | $489.78 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $229.09 Typical High $257.04 | Professional | 53 · Discontinued | $194.98 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $870.96 Typical High $954.99 | Professional | 54 · Surgery only | $724.44 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $173.78 Typical High $190.55 | Professional | 55 · Aftercare only | $144.54 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $114.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $97.72 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $812.83 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $676.08 | $812.83 | $891.25 |
Where Missouri sits
The same service costs 16.6 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
$1,445
AK $4,677TX $282
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.