How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,122 to $8,913Professionalmedian $692 · 10th to 90th $537 to $1,622
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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $676.08 | Professional | None | $489.78 | $588.84 | $676.08 |
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 $562.34 Median $660.69 Typical High $933.25 | Professional | None | $562.34 | $660.69 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,000.00 Typical High $1,380.38 | Professional | 50 · Both sides | $831.76 | $1,000.00 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $104.71 Typical High $147.91 | Professional | 80 · Assistant surgeon | $89.13 | $104.71 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $93.33 Typical High $128.82 | Professional | AS · PA/NP assist | $77.62 | $93.33 | $128.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $776.25 | Professional | None | $537.03 | $575.44 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,162.28 | Facility | None | $602.56 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $1,148.15 | Professional | None | $478.63 | $602.56 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $3,715.35 Typical High $16,218.10 | Facility | None | $741.31 | $3,715.35 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $954.99 Typical High $4,365.16 | Professional | None | $575.44 | $954.99 | $4,365.16 |
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 $501.19 Median $707.95 Typical High $1,148.15 | Professional | None | $501.19 | $707.95 | $1,148.15 |
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 $245.47 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $245.47 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $117.49 Typical High $128.82 | Professional | 53 · Discontinued | $97.72 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $363.08 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $72.44 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $58.88 Typical High $64.57 | Professional | 56 · Pre-op care only | $48.98 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $338.84 | $407.38 | $446.68 |
Where Missouri sits
The same service costs 8.3 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· 33rd of 51
$708
AK $2,344TX $282
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.