How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,096 to $8,318Professionalmedian $1,096 · 10th to 90th $832 to $3,090
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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,096.48 | Professional | None | $776.25 | $912.01 | $1,096.48 |
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 $891.25 Median $1,047.13 Typical High $1,479.11 | Professional | None | $891.25 | $1,047.13 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $933.25 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $234.42 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $204.17 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $204.17 |
BCBS Kansas City Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,202.26 | Professional | None | $831.76 | $891.25 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,951.21 Typical High $4,365.16 | Facility | None | $707.95 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,862.09 | Professional | None | $758.58 | $1,000.00 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,884.03 Typical High $16,595.87 | Facility | None | $54.95 | $2,884.03 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,513.56 Typical High $8,317.64 | Professional | None | $912.01 | $1,513.56 | $8,317.64 |
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 $812.83 Median $1,122.02 Typical High $1,819.70 | Professional | None | $812.83 | $1,122.02 | $1,819.70 |
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 $389.05 Median $457.09 Typical High $512.86 | Professional | 52 · Reduced service | $389.05 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $181.97 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $691.83 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $138.04 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $91.20 Typical High $102.33 | Professional | 56 · Pre-op care only | $77.62 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $645.65 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $645.65 | $707.95 |
Where Missouri sits
The same service costs 20.0 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· 31st of 51
$1,122
AK $3,715TX $186
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.