How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,148 to $8,511Professionalmedian $1,585 · 10th to 90th $1,259 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 $1,513.56 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,513.56 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,380.38 | $1,513.56 |
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 $1,318.26 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,023.29 Typical High $1,412.54 | Professional | 62 · Two surgeons | $831.76 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $263.03 Typical High $354.81 | Professional | 80 · Assistant surgeon | $208.93 | $263.03 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $223.87 Typical High $316.23 | Professional | AS · PA/NP assist | $186.21 | $223.87 | $316.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,318.26 | $1,737.80 |
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 $1,122.02 Median $1,513.56 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,513.56 | $2,754.23 |
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 $1,288.25 Median $2,238.72 Typical High $14,791.08 | Professional | None | $1,288.25 | $2,238.72 | $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 $1,230.27 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,621.81 | $2,691.53 |
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 $575.44 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $575.44 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $275.42 Typical High $302.00 | Professional | 53 · Discontinued | $229.09 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $138.04 Typical High $151.36 | Professional | 56 · Pre-op care only | $114.82 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $1,071.52 |
Where Missouri sits
The same service costs 17.0 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· 29th of 51
$1,698
AK $5,495TX $324
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.