How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,259 to $13,490Professionalmedian $1,288 · 10th to 90th $955 to $2,884
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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,230.27 | Professional | None | $851.14 | $1,023.29 | $1,230.27 |
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 $1,047.13 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,318.26 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,949.84 Typical High $2,570.40 | Professional | 50 · Both sides | $1,548.82 | $1,949.84 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $812.83 Typical High $1,071.52 | Professional | 62 · Two surgeons | $645.65 | $812.83 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $275.42 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $181.97 Typical High $239.88 | Professional | AS · PA/NP assist | $144.54 | $181.97 | $239.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,318.26 | Professional | None | $933.25 | $1,000.00 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $8,912.51 Typical High $13,182.57 | Facility | None | $645.65 | $8,912.51 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $2,089.30 | Professional | None | $851.14 | $1,096.48 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $5,128.61 Typical High $47,863.01 | Facility | None | $1,174.90 | $5,128.61 | $47,863.01 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $7,585.78 | Professional | None | $1,023.29 | $1,737.80 | $7,585.78 |
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 $891.25 Median $1,288.25 Typical High $2,041.74 | Professional | None | $891.25 | $1,288.25 | $2,041.74 |
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 $426.58 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $426.58 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $204.17 Typical High $229.09 | Professional | 53 · Discontinued | $173.78 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $776.25 Typical High $851.14 | Professional | 54 · Surgery only | $645.65 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $154.88 Typical High $169.82 | Professional | 55 · Aftercare only | $128.82 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $102.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $85.11 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $724.44 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $602.56 | $724.44 | $794.33 |
Where Missouri sits
The same service costs 7.2 times more in Alaska than in Hawaii. 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 $19,657HI $2,734
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.