How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,148 to $8,318Professionalmedian $1,738 · 10th to 90th $1,318 to $3,802
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 $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,412.54 | $1,698.24 |
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 $1,412.54 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,737.80 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,071.52 Typical High $1,479.11 | Professional | 62 · Two surgeons | $891.25 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $275.42 Typical High $371.54 | Professional | 80 · Assistant surgeon | $229.09 | $275.42 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $239.88 Typical High $323.59 | Professional | AS · PA/NP assist | $199.53 | $239.88 | $323.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,380.38 | $1,862.09 |
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 $1,174.90 Median $1,584.89 Typical High $2,951.21 | Professional | None | $1,174.90 | $1,584.89 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,818.38 Typical High $11,220.18 | Facility | None | $54.95 | $2,818.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $2,570.40 Typical High $13,489.63 | Professional | None | $1,445.44 | $2,570.40 | $13,489.63 |
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 $1,258.93 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,862.09 | $2,818.38 |
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 $588.84 Median $707.95 Typical High $776.25 | Professional | 52 · Reduced service | $588.84 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $281.84 Typical High $316.23 | Professional | 53 · Discontinued | $239.88 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $891.25 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $177.83 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $141.25 Typical High $154.88 | Professional | 56 · Pre-op care only | $117.49 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $831.76 | $977.24 | $1,096.48 |
Where Missouri sits
The same service costs 17.8 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
$1,820
AK $5,623TX $316
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.