How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,148 to $8,913Professionalmedian $891 · 10th to 90th $661 to $2,089
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 $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $851.14 | Professional | None | $602.56 | $724.44 | $851.14 |
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 $707.95 Median $891.25 Typical High $1,202.26 | Professional | None | $707.95 | $891.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,348.96 Typical High $1,778.28 | Professional | 50 · Both sides | $1,071.52 | $1,348.96 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $562.34 Typical High $741.31 | Professional | 62 · Two surgeons | $446.68 | $562.34 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $144.54 Typical High $190.55 | Professional | 80 · Assistant surgeon | $112.20 | $144.54 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $125.89 Typical High $165.96 | Professional | AS · PA/NP assist | $100.00 | $125.89 | $165.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $933.25 | Professional | None | $660.69 | $707.95 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $3,801.89 | Facility | None | $912.01 | $2,089.30 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,445.44 | Professional | None | $602.56 | $758.58 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $3,801.89 Typical High $26,302.68 | Facility | None | $891.25 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $5,754.40 | Professional | None | $707.95 | $1,202.26 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,412.54 | Professional | None | $630.96 | $891.25 | $1,412.54 |
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 $302.00 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $562.34 |
Where Missouri sits
The same service costs 8.7 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· 26th of 51
$933
AK $2,951TX $339
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.