How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,096 to $9,333Professionalmedian $1,995 · 10th to 90th $1,549 to $4,571
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 $2,187.76 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,187.76 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,778.28 | $2,041.74 |
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 $1,584.89 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,949.84 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,230.27 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,000.00 | $1,230.27 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $316.23 Typical High $426.58 | Professional | 80 · Assistant surgeon | $257.04 | $316.23 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $275.42 Typical High $371.54 | Professional | AS · PA/NP assist | $223.87 | $275.42 | $371.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,778.28 | $1,905.46 | $2,454.71 |
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 $1,479.11 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,905.46 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,090.30 Typical High $15,488.17 | Facility | None | $54.95 | $3,090.30 | $15,488.17 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $2,884.03 Typical High $14,454.40 | Professional | None | $1,621.81 | $2,884.03 | $14,454.40 |
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 $1,548.82 Median $1,995.26 Typical High $3,548.13 | Professional | None | $1,548.82 | $1,995.26 | $3,548.13 |
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 $741.31 Median $891.25 Typical High $977.24 | Professional | 52 · Reduced service | $741.31 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $363.08 Typical High $398.11 | Professional | 53 · Discontinued | $302.00 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,348.96 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,122.02 | $1,348.96 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $269.15 Typical High $295.12 | Professional | 55 · Aftercare only | $223.87 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $177.83 Typical High $194.98 | Professional | 56 · Pre-op care only | $147.91 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,258.93 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,258.93 | $1,380.38 |
Where Missouri sits
The same service costs 11.2 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
$2,042
AK $7,244TX $646
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.