How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,148 to $7,943Professionalmedian $2,754 · 10th to 90th $1,995 to $8,318
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 $2,290.87 Median $5,623.41 Typical High $10,715.19 | Facility | None | $2,290.87 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,819.70 | $2,137.96 | $2,511.89 |
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 $2,290.87 Median $2,818.38 Typical High $3,715.35 | Professional | None | $2,290.87 | $2,818.38 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $457.09 Typical High $588.84 | Professional | 80 · Assistant surgeon | $363.08 | $457.09 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $398.11 Typical High $512.86 | Professional | AS · PA/NP assist | $316.23 | $398.11 | $512.86 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,862.09 | $1,995.26 | $2,818.38 |
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 $1,778.28 Median $2,344.23 Typical High $4,677.35 | Professional | None | $1,778.28 | $2,344.23 | $4,677.35 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,090.30 Typical High $11,481.54 | Facility | None | $54.95 | $3,090.30 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $2,187.76 Median $3,715.35 Typical High $22,387.21 | Professional | None | $2,187.76 | $3,715.35 | $22,387.21 |
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 $1,905.46 Median $2,754.23 Typical High $4,265.80 | Professional | None | $1,905.46 | $2,754.23 | $4,265.80 |
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 $912.01 Median $1,071.52 Typical High $1,202.26 | Professional | 52 · Reduced service | $912.01 | $1,071.52 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $426.58 Typical High $478.63 | Professional | 53 · Discontinued | $363.08 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,621.81 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,380.38 | $1,621.81 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $323.59 Typical High $363.08 | Professional | 55 · Aftercare only | $275.42 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $213.80 Typical High $239.88 | Professional | 56 · Pre-op care only | $181.97 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,513.56 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,513.56 | $1,698.24 |
Where Missouri sits
The same service costs 21.9 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
$2,818
AK $8,710TX $398
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.