How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,413 to $11,749Professionalmedian $1,905 · 10th to 90th $1,479 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 $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,584.89 | $1,995.26 |
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 $1,548.82 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,819.70 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $2,754.23 Typical High $3,890.45 | Professional | 50 · Both sides | $2,344.23 | $2,754.23 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,148.15 Typical High $1,621.81 | Professional | 62 · Two surgeons | $977.24 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $295.12 Typical High $416.87 | Professional | 80 · Assistant surgeon | $245.47 | $295.12 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $257.04 Typical High $363.08 | Professional | AS · PA/NP assist | $218.78 | $257.04 | $363.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,479.11 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,548.82 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $5,248.07 Typical High $7,244.36 | Facility | None | $1,202.26 | $5,248.07 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,737.80 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $27,542.29 | Facility | None | $1,513.56 | $4,466.84 | $27,542.29 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $23,988.33 | Professional | None | $1,621.81 | $2,691.53 | $23,988.33 |
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 $1,445.44 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,995.26 | $3,162.28 |
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 $676.08 Median $794.33 Typical High $891.25 | Professional | 52 · Reduced service | $676.08 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $316.23 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,202.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,023.29 | $1,202.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $239.88 Typical High $269.15 | Professional | 55 · Aftercare only | $204.17 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $158.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $134.90 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,122.02 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $954.99 | $1,122.02 | $1,258.93 |
Where Missouri sits
The same service costs 20.0 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· 32nd of 51
$1,950
AK $6,457TX $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.