How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,259 to $8,913Professionalmedian $1,202 · 10th to 90th $912 to $3,467
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 $851.14 Median $1,000.00 Typical High $1,202.26 | Professional | None | $851.14 | $1,000.00 | $1,202.26 |
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 $977.24 Median $1,174.90 Typical High $1,621.81 | Professional | None | $977.24 | $1,174.90 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,737.80 Typical High $2,454.71 | Professional | 50 · Both sides | $1,445.44 | $1,737.80 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $741.31 Typical High $1,023.29 | Professional | 62 · Two surgeons | $616.60 | $741.31 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $186.21 Typical High $263.03 | Professional | 80 · Assistant surgeon | $154.88 | $186.21 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $162.18 Typical High $229.09 | Professional | AS · PA/NP assist | $134.90 | $162.18 | $229.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,288.25 | Professional | None | $891.25 | $954.99 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,951.21 Typical High $4,365.16 | Facility | None | $741.31 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $2,041.74 | Professional | None | $831.76 | $1,096.48 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $2,884.03 Typical High $13,803.84 | Facility | None | $1,202.26 | $2,884.03 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $8,511.38 | Professional | None | $1,000.00 | $1,659.59 | $8,511.38 |
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 $891.25 Median $1,258.93 Typical High $1,995.26 | Professional | None | $891.25 | $1,258.93 | $1,995.26 |
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 $426.58 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $426.58 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $199.53 Typical High $223.87 | Professional | 53 · Discontinued | $169.82 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $645.65 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $128.82 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $85.11 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $602.56 | $707.95 | $794.33 |
Where Missouri sits
The same service costs 18.2 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· 32nd of 51
$1,259
AK $4,074TX $224
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.