How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,175 to $8,710Professionalmedian $1,698 · 10th to 90th $1,318 to $3,715
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 $1,202.26 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,202.26 | $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 $1,698.24 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,698.24 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $371.54 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $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 $1,288.25 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,380.38 | $1,819.70 |
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 $1,174.90 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,584.89 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,951.21 Typical High $16,595.87 | Facility | None | $54.95 | $2,951.21 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $16,982.44 | Professional | None | $1,445.44 | $2,344.23 | $16,982.44 |
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 $1,778.28 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,778.28 | $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 $602.56 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $602.56 | $707.95 | $794.33 |
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 $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $891.25 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $239.88 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $120.23 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $831.76 | $1,000.00 | $1,096.48 |
Where Missouri sits
The same service costs 19.5 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· 31st of 51
$1,778
AK $5,754TX $295
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.