How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,000 to $7,079Professionalmedian $1,349 · 10th to 90th $977 to $3,090
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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,288.25 | Professional | None | $870.96 | $1,000.00 | $1,288.25 |
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 $1,122.02 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $851.14 Typical High $1,148.15 | Professional | 62 · Two surgeons | $707.95 | $851.14 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $218.78 Typical High $288.40 | Professional | 80 · Assistant surgeon | $177.83 | $218.78 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $190.55 Typical High $251.19 | Professional | AS · PA/NP assist | $154.88 | $190.55 | $251.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,348.96 | Professional | None | $912.01 | $977.24 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,951.21 Typical High $4,365.16 | Facility | None | $707.95 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $2,238.72 | Professional | None | $831.76 | $1,230.27 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,949.84 Typical High $16,595.87 | Facility | None | $54.95 | $1,949.84 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $7,585.78 | Professional | None | $1,096.48 | $1,905.46 | $7,585.78 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,137.96 | Professional | None | $977.24 | $1,412.54 | $2,137.96 |
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 $436.52 Median $501.19 Typical High $575.44 | Professional | 52 · Reduced service | $436.52 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $204.17 Typical High $229.09 | Professional | 53 · Discontinued | $173.78 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $645.65 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $128.82 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $100.00 Typical High $114.82 | Professional | 56 · Pre-op care only | $87.10 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $602.56 | $707.95 | $794.33 |
Where Missouri sits
The same service costs 7.9 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· 26th of 51
$1,445
AK $4,074TX $513
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.