How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,259 to $8,913Professionalmedian $955 · 10th to 90th $724 to $3,388
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 $1,778.28 Median $5,623.41 Typical High $13,803.84 | Facility | None | $1,778.28 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,174.90 | Professional | None | $676.08 | $794.33 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $758.58 Median $954.99 Typical High $1,318.26 | Professional | None | $758.58 | $954.99 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,445.44 Typical High $1,949.84 | Professional | 50 · Both sides | $1,148.15 | $1,445.44 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $602.56 Typical High $812.83 | Professional | 62 · Two surgeons | $478.63 | $602.56 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $151.36 Typical High $208.93 | Professional | 80 · Assistant surgeon | $123.03 | $151.36 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $134.90 Typical High $181.97 | Professional | AS · PA/NP assist | $107.15 | $134.90 | $181.97 |
BCBS Kansas City Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,023.29 | Professional | None | $707.95 | $758.58 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $5,248.07 | Facility | None | $1,202.26 | $3,801.89 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,621.81 | Professional | None | $660.69 | $851.14 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $2,884.03 Typical High $16,595.87 | Facility | None | $1,023.29 | $2,884.03 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,318.26 Typical High $6,918.31 | Professional | None | $794.33 | $1,318.26 | $6,918.31 |
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 $707.95 Median $1,023.29 Typical High $1,584.89 | Professional | None | $707.95 | $1,023.29 | $1,584.89 |
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 $338.84 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $338.84 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $134.90 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $512.86 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $478.63 | $562.34 | $630.96 |
Where Missouri sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $10,315KY $2,095
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.