How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,096 to $8,913Professionalmedian $1,622 · 10th to 90th $1,230 to $3,890
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 $1,258.93 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,513.56 | $1,862.09 |
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 $1,202.26 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,513.56 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,290.87 Typical High $3,311.31 | Professional | 50 · Both sides | $1,819.70 | $2,290.87 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $954.99 Typical High $1,412.54 | Professional | 62 · Two surgeons | $758.58 | $954.99 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $239.88 Typical High $354.81 | Professional | 80 · Assistant surgeon | $194.98 | $239.88 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $213.80 Typical High $309.03 | Professional | AS · PA/NP assist | $169.82 | $213.80 | $309.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,479.11 | $1,949.84 |
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 $1,202.26 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,659.59 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,019.95 Typical High $10,471.29 | Facility | None | $54.95 | $3,019.95 | $10,471.29 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $10,964.78 | Professional | None | $1,348.96 | $2,454.71 | $10,964.78 |
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 $1,258.93 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,862.09 | $3,019.95 |
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 $630.96 Median $758.58 Typical High $831.76 | Professional | 52 · Reduced service | $630.96 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $302.00 Typical High $331.13 | Professional | 53 · Discontinued | $251.19 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,148.15 Typical High $1,258.93 | Professional | 54 · Surgery only | $954.99 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $229.09 Typical High $251.19 | Professional | 55 · Aftercare only | $190.55 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $151.36 Typical High $165.96 | Professional | 56 · Pre-op care only | $125.89 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $891.25 | $1,071.52 | $1,174.90 |
Where Missouri sits
The same service costs 5.5 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 $15,938KY $2,890
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.