How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,148 to $7,943Professionalmedian $1,950 · 10th to 90th $1,479 to $4,169
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 $1,318.26 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,584.89 | $1,905.46 |
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 $1,621.81 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,621.81 | $1,949.84 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $309.03 Typical High $416.87 | Professional | 80 · Assistant surgeon | $263.03 | $309.03 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $269.15 Typical High $363.08 | Professional | AS · PA/NP assist | $229.09 | $269.15 | $363.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,513.56 | $2,041.74 |
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 $1,288.25 Median $1,819.70 Typical High $3,235.94 | Professional | None | $1,288.25 | $1,819.70 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,691.53 Typical High $11,481.54 | Facility | None | $54.95 | $2,691.53 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $15,488.17 | Professional | None | $1,621.81 | $2,691.53 | $15,488.17 |
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 $1,412.54 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,412.54 | $2,041.74 | $3,162.28 |
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 $660.69 Median $776.25 Typical High $870.96 | Professional | 52 · Reduced service | $660.69 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $316.23 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,174.90 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,000.00 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $234.42 Typical High $263.03 | Professional | 55 · Aftercare only | $199.53 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $158.49 Typical High $173.78 | Professional | 56 · Pre-op care only | $131.83 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,096.48 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $933.25 | $1,096.48 | $1,230.27 |
Where Missouri sits
The same service costs 17.4 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
$2,042
AK $6,310TX $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.