How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,096 to $10,471Professionalmedian $776 · 10th to 90th $589 to $2,042
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 $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $741.31 | Professional | None | $537.03 | $645.65 | $741.31 |
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 $616.60 Median $776.25 Typical High $1,047.13 | Professional | None | $616.60 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,148.15 Typical High $1,548.82 | Professional | 50 · Both sides | $933.25 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $123.03 Typical High $165.96 | Professional | 80 · Assistant surgeon | $100.00 | $123.03 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $107.15 Typical High $144.54 | Professional | AS · PA/NP assist | $87.10 | $107.15 | $144.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $831.76 | Professional | None | $588.84 | $630.96 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,630.78 Typical High $5,370.32 | Facility | None | $758.58 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,258.93 | Professional | None | $524.81 | $660.69 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $2,754.23 Typical High $26,302.68 | Facility | None | $851.14 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,047.13 Typical High $4,677.35 | Professional | None | $630.96 | $1,047.13 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,258.93 | Professional | None | $549.54 | $776.25 | $1,258.93 |
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 $269.15 Median $316.23 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $478.63 Typical High $524.81 | Professional | 54 · Surgery only | $398.11 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $79.43 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $446.68 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $371.54 | $446.68 | $489.78 |
Where Missouri sits
The same service costs 8.3 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
$832
AK $2,570TX $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.