How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,148 to $8,913Professionalmedian $2,042 · 10th to 90th $1,514 to $6,166
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 $1,737.80 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,737.80 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,621.81 | $1,949.84 |
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 $1,659.59 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,659.59 | $2,041.74 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $323.59 Typical High $436.52 | Professional | 80 · Assistant surgeon | $269.15 | $323.59 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $288.40 Typical High $389.05 | Professional | AS · PA/NP assist | $234.42 | $288.40 | $389.05 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,513.56 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,801.89 Typical High $5,495.41 | Facility | None | $707.95 | $3,801.89 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,380.38 | $1,778.28 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,951.21 Typical High $20,892.96 | Facility | None | $54.95 | $2,951.21 | $20,892.96 |
Medica Setting Professional Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $16,218.10 | Professional | None | $1,659.59 | $2,754.23 | $16,218.10 |
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 $1,445.44 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,445.44 | $2,089.30 | $3,235.94 |
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 $691.83 Median $812.83 Typical High $912.01 | Professional | 52 · Reduced service | $691.83 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $331.13 Typical High $363.08 | Professional | 53 · Discontinued | $275.42 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,230.27 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,047.13 | $1,230.27 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $245.47 Typical High $275.42 | Professional | 55 · Aftercare only | $208.93 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $162.18 Typical High $181.97 | Professional | 56 · Pre-op care only | $138.04 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,148.15 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $977.24 | $1,148.15 | $1,288.25 |
Where Missouri sits
The same service costs 20.4 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
$2,089
AK $6,607TX $324
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.