How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,096 to $10,471Professionalmedian $1,995 · 10th to 90th $1,549 to $5,623
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 $6,309.57 Typical High $21,877.62 | Facility | None | $2,511.89 | $6,309.57 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,698.24 | $1,905.46 |
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 $1,659.59 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,659.59 | $1,949.84 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,230.27 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,047.13 | $1,230.27 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $316.23 Typical High $426.58 | Professional | 80 · Assistant surgeon | $263.03 | $316.23 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $275.42 Typical High $380.19 | Professional | AS · PA/NP assist | $234.42 | $275.42 | $380.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,621.81 | $1,737.80 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $6,760.83 Typical High $9,772.37 | Facility | None | $707.95 | $6,760.83 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,412.54 | $1,819.70 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,019.95 Typical High $15,488.17 | Facility | None | $54.95 | $3,019.95 | $15,488.17 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $15,848.93 | Professional | None | $1,621.81 | $2,691.53 | $15,848.93 |
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 $1,445.44 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,445.44 | $2,089.30 | $3,311.31 |
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 $707.95 Median $831.76 Typical High $933.25 | Professional | 52 · Reduced service | $707.95 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $338.84 Typical High $371.54 | Professional | 53 · Discontinued | $281.84 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,258.93 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,047.13 | $1,258.93 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $251.19 Typical High $275.42 | Professional | 55 · Aftercare only | $208.93 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $169.82 Typical High $186.21 | Professional | 56 · Pre-op care only | $141.25 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,174.90 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $977.24 | $1,174.90 | $1,288.25 |
Where Missouri sits
The same service costs 5.3 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 $17,981KY $3,363
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.