How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,096 to $8,710Professionalmedian $1,479 · 10th to 90th $1,122 to $4,786
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 $1,380.38 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,380.38 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,258.93 | $1,380.38 |
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 $1,202.26 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,445.44 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,187.76 Typical High $3,019.95 | Professional | 50 · Both sides | $1,778.28 | $2,187.76 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $912.01 Typical High $1,258.93 | Professional | 62 · Two surgeons | $758.58 | $912.01 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $234.42 Typical High $323.59 | Professional | 80 · Assistant surgeon | $190.55 | $234.42 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $204.17 Typical High $281.84 | Professional | AS · PA/NP assist | $165.96 | $204.17 | $281.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,202.26 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,801.89 Typical High $5,623.41 | Facility | None | $707.95 | $3,801.89 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,348.96 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,951.21 Typical High $13,803.84 | Facility | None | $54.95 | $2,951.21 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $14,791.08 | Professional | None | $1,202.26 | $2,041.74 | $14,791.08 |
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 $1,096.48 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,513.56 | $2,454.71 |
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 $524.81 Median $616.60 Typical High $691.83 | Professional | 52 · Reduced service | $524.81 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $251.19 Typical High $275.42 | Professional | 53 · Discontinued | $208.93 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $933.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $776.25 | $933.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $158.49 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $104.71 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $870.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $724.44 | $870.96 | $954.99 |
Where Missouri sits
The same service costs 16.2 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
$1,549
AK $5,012TX $309
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.