How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,148 to $7,943Professionalmedian $2,344 · 10th to 90th $1,660 to $5,248
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 $1,905.46 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,905.46 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,819.70 | $2,137.96 |
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 $1,905.46 Median $2,398.83 Typical High $3,090.30 | Professional | None | $1,905.46 | $2,398.83 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $380.19 Typical High $501.19 | Professional | 80 · Assistant surgeon | $302.00 | $380.19 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $338.84 Typical High $436.52 | Professional | AS · PA/NP assist | $269.15 | $338.84 | $436.52 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,698.24 | $2,344.23 |
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 $1,513.56 Median $1,949.84 Typical High $3,981.07 | Professional | None | $1,513.56 | $1,949.84 | $3,981.07 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,754.23 Typical High $11,481.54 | Facility | None | $54.95 | $2,754.23 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $18,197.01 | Professional | None | $1,819.70 | $3,162.28 | $18,197.01 |
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 $1,584.89 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,584.89 | $2,398.83 | $3,630.78 |
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 $758.58 Median $891.25 Typical High $1,000.00 | Professional | 52 · Reduced service | $758.58 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $363.08 Typical High $407.38 | Professional | 53 · Discontinued | $309.03 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,348.96 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,148.15 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $269.15 Typical High $302.00 | Professional | 55 · Aftercare only | $229.09 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $181.97 Typical High $199.53 | Professional | 56 · Pre-op care only | $151.36 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,258.93 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,258.93 | $1,412.54 |
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· 27th of 51
$2,399
AK $7,244TX $363
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.