How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,259 to $17,783Professionalmedian $1,202 · 10th to 90th $891 to $3,715
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 $10,715.19 | Facility | None | $2,089.30 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,174.90 | Professional | None | $794.33 | $954.99 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,890.45 Typical High $14,791.08 | Facility | None | $1,412.54 | $3,890.45 | $14,791.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,621.81 | Professional | None | $954.99 | $1,202.26 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,819.70 Typical High $2,398.83 | Professional | 50 · Both sides | $1,445.44 | $1,819.70 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $758.58 Typical High $1,023.29 | Professional | 62 · Two surgeons | $602.56 | $758.58 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $190.55 Typical High $251.19 | Professional | 80 · Assistant surgeon | $151.36 | $190.55 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $169.82 Typical High $223.87 | Professional | AS · PA/NP assist | $134.90 | $169.82 | $223.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,230.27 | Professional | None | $870.96 | $933.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $4,570.88 Typical High $6,760.83 | Facility | None | $912.01 | $4,570.88 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,949.84 | Professional | None | $794.33 | $1,023.29 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $5,128.61 Typical High $26,302.68 | Facility | None | $1,174.90 | $5,128.61 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,621.81 Typical High $6,918.31 | Professional | None | $954.99 | $1,621.81 | $6,918.31 |
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 $831.76 Median $1,202.26 Typical High $1,905.46 | Professional | None | $831.76 | $1,202.26 | $1,905.46 |
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 $398.11 Median $478.63 Typical High $524.81 | Professional | 52 · Reduced service | $398.11 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $190.55 Typical High $208.93 | Professional | 53 · Discontinued | $158.49 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $602.56 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $144.54 Typical High $158.49 | Professional | 55 · Aftercare only | $120.23 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $95.50 Typical High $104.71 | Professional | 56 · Pre-op care only | $79.43 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $562.34 | $676.08 | $741.31 |
Where Missouri sits
The same service costs 7.9 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· 28th of 51
$1,288
AK $3,890TX $490
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.