How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,096 to $8,913Professionalmedian $2,692 · 10th to 90th $2,089 to $6,166
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 $2,511.89 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,511.89 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $2,818.38 | Professional | None | $2,089.30 | $2,511.89 | $2,818.38 |
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 $2,630.27 Typical High $3,981.07 | Professional | None | $2,089.30 | $2,630.27 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,659.59 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,318.26 | $1,659.59 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $416.87 Typical High $630.96 | Professional | 80 · Assistant surgeon | $331.13 | $416.87 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $363.08 Typical High $549.54 | Professional | AS · PA/NP assist | $295.12 | $363.08 | $549.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $3,235.94 | Professional | None | $2,290.87 | $2,454.71 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,630.78 Typical High $5,370.32 | Facility | None | $707.95 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,691.53 Typical High $4,897.79 | Professional | None | $2,041.74 | $2,691.53 | $4,897.79 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,311.31 Typical High $12,882.50 | Facility | None | $54.95 | $3,311.31 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $2,344.23 Median $3,801.89 Typical High $18,620.87 | Professional | None | $2,344.23 | $3,801.89 | $18,620.87 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $4,897.79 | Professional | None | $2,187.76 | $3,019.95 | $4,897.79 |
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 $1,023.29 Median $1,230.27 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,023.29 | $1,230.27 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $501.19 Typical High $549.54 | Professional | 53 · Discontinued | $416.87 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,862.09 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,548.82 | $1,862.09 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $371.54 Typical High $407.38 | Professional | 55 · Aftercare only | $309.03 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $251.19 Typical High $275.42 | Professional | 56 · Pre-op care only | $208.93 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,737.80 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,737.80 | $1,905.46 |
Where Missouri sits
The same service costs 4.0 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.
Physician feeFacility fee
AK $19,772TX $4,915
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.