How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,122 to $10,471Professionalmedian $933 · 10th to 90th $708 to $2,188
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 $645.65 Median $776.25 Typical High $912.01 | Professional | None | $645.65 | $776.25 | $912.01 |
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 $758.58 Median $912.01 Typical High $1,258.93 | Professional | None | $758.58 | $912.01 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,380.38 Typical High $1,862.09 | Professional | 50 · Both sides | $1,122.02 | $1,380.38 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $575.44 Typical High $794.33 | Professional | 62 · Two surgeons | $478.63 | $575.44 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $144.54 Typical High $199.53 | Professional | 80 · Assistant surgeon | $120.23 | $144.54 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $125.89 Typical High $173.78 | Professional | AS · PA/NP assist | $104.71 | $125.89 | $173.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,023.29 | Professional | None | $724.44 | $776.25 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,630.78 Typical High $5,370.32 | Facility | None | $602.56 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,548.82 | Professional | None | $645.65 | $812.83 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,801.89 Typical High $19,952.62 | Facility | None | $933.25 | $3,801.89 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,288.25 Typical High $7,244.36 | Professional | None | $758.58 | $1,288.25 | $7,244.36 |
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 $676.08 Median $954.99 Typical High $1,513.56 | Professional | None | $676.08 | $954.99 | $1,513.56 |
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 $323.59 Median $389.05 Typical High $426.58 | Professional | 52 · Reduced service | $323.59 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $154.88 Typical High $169.82 | Professional | 53 · Discontinued | $128.82 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $588.84 Typical High $645.65 | Professional | 54 · Surgery only | $489.78 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $117.49 Typical High $128.82 | Professional | 55 · Aftercare only | $97.72 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $77.62 Typical High $85.11 | Professional | 56 · Pre-op care only | $64.57 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $549.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $457.09 | $549.54 | $602.56 |
Where Missouri sits
The same service costs 18.2 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· 30th of 51
$1,000
AK $3,162TX $174
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.