How much rates vary
Facilitymedian $2,344 · 10th to 90th $631 to $7,079Professionalmedian $447 · 10th to 90th $302 to $2,455
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 $537.03 Median $4,677.35 Typical High $7,762.47 | Facility | None | $537.03 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $562.34 | Professional | None | $275.42 | $426.58 | $562.34 |
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 $288.40 Median $338.84 Typical High $501.19 | Professional | None | $288.40 | $338.84 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $512.86 Typical High $741.31 | Professional | 50 · Both sides | $436.52 | $512.86 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $53.70 Typical High $79.43 | Professional | 80 · Assistant surgeon | $45.71 | $53.70 | $79.43 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $47.86 Typical High $69.18 | Professional | AS · PA/NP assist | $40.74 | $47.86 | $69.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $660.69 | Professional | None | $316.23 | $537.03 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $2,691.53 | Facility | None | $588.84 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $794.33 | Professional | None | $275.42 | $457.09 | $794.33 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $26,302.68 | Facility | None | $537.03 | $1,548.82 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $2,454.71 Typical High $3,801.89 | Professional | None | $537.03 | $2,454.71 | $3,801.89 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $812.83 | Professional | None | $309.03 | $501.19 | $812.83 |
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 $138.04 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $138.04 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $85.11 Typical High $107.15 | Professional | 53 · Discontinued | $56.23 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $323.59 Typical High $398.11 | Professional | 54 · Surgery only | $208.93 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $41.69 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $42.66 Typical High $53.70 | Professional | 56 · Pre-op care only | $27.54 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $302.00 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $194.98 | $302.00 | $371.54 |
Where Missouri sits
The same service costs 5.1 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· 30th of 51
$501
AK $1,585TX $309
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.