How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,175 to $12,882Professionalmedian $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 $1,698.24 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 $489.78 Median $588.84 Typical High $912.01 | Professional | None | $489.78 | $588.84 | $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 $562.34 Median $691.83 Typical High $954.99 | Professional | None | $562.34 | $691.83 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,047.13 Typical High $1,412.54 | Professional | 50 · Both sides | $851.14 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $109.65 Typical High $151.36 | Professional | 80 · Assistant surgeon | $91.20 | $109.65 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $97.72 Typical High $131.83 | Professional | AS · PA/NP assist | $79.43 | $97.72 | $131.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $776.25 | Professional | None | $537.03 | $588.84 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,570.88 Typical High $6,760.83 | Facility | None | $645.65 | $4,570.88 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,174.90 | Professional | None | $489.78 | $616.60 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $5,011.87 Typical High $26,302.68 | Facility | None | $831.76 | $5,011.87 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $977.24 Typical High $4,265.80 | Professional | None | $575.44 | $977.24 | $4,265.80 |
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 $512.86 Median $707.95 Typical High $1,148.15 | Professional | None | $512.86 | $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 $295.12 Typical High $323.59 | Professional | 52 · Reduced service | $245.47 | $295.12 | $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 $371.54 Median $436.52 Typical High $489.78 | Professional | 54 · Surgery only | $371.54 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $74.13 | $89.13 | $97.72 |
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 $346.74 Median $407.38 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $346.74 | $407.38 | $457.09 |
Where Missouri sits
The same service costs 7.8 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· 26th of 51
$759
AK $2,399TX $309
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.