How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,148 to $8,511Professionalmedian $2,570 · 10th to 90th $1,995 to $6,026
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 $1,905.46 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,905.46 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,511.89 | Professional | None | $1,905.46 | $2,238.72 | $2,511.89 |
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 $2,089.30 Median $2,570.40 Typical High $3,630.78 | Professional | None | $2,089.30 | $2,570.40 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,621.81 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,288.25 | $1,621.81 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $407.38 Typical High $575.44 | Professional | 80 · Assistant surgeon | $331.13 | $407.38 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $363.08 Typical High $512.86 | Professional | AS · PA/NP assist | $288.40 | $363.08 | $512.86 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,995.26 | $2,137.96 | $2,884.03 |
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 $1,862.09 Median $2,454.71 Typical High $4,168.69 | Professional | None | $1,862.09 | $2,454.71 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,090.30 Typical High $20,892.96 | Facility | None | $54.95 | $3,090.30 | $20,892.96 |
Medica Setting Professional Modifier None Typical Low $2,137.96 Median $3,630.78 Typical High $24,547.09 | Professional | None | $2,137.96 | $3,630.78 | $24,547.09 |
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 $1,995.26 Median $2,630.27 Typical High $4,466.84 | Professional | None | $1,995.26 | $2,630.27 | $4,466.84 |
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 $954.99 Median $1,122.02 Typical High $1,258.93 | Professional | 52 · Reduced service | $954.99 | $1,122.02 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $446.68 Typical High $501.19 | Professional | 53 · Discontinued | $380.19 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,698.24 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,412.54 | $1,698.24 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $338.84 Typical High $371.54 | Professional | 55 · Aftercare only | $281.84 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $223.87 Typical High $251.19 | Professional | 56 · Pre-op care only | $190.55 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,584.89 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,584.89 | $1,737.80 |
Where Missouri sits
The same service costs 21.4 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· 29th of 51
$2,692
AK $9,120TX $427
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.