How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,259 to $13,183Professionalmedian $1,288 · 10th to 90th $955 to $3,548
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 $870.96 Median $1,047.13 Typical High $1,202.26 | Professional | None | $870.96 | $1,047.13 | $1,202.26 |
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 $1,023.29 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,318.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,995.26 Typical High $2,691.53 | Professional | 50 · Both sides | $1,548.82 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $831.76 Typical High $1,122.02 | Professional | 62 · Two surgeons | $645.65 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $281.84 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $186.21 Typical High $251.19 | Professional | AS · PA/NP assist | $144.54 | $186.21 | $251.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,348.96 | Professional | None | $933.25 | $1,023.29 | $1,348.96 |
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 $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 $26,302.68 | Facility | None | $1,174.90 | $5,128.61 | $26,302.68 |
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 $912.01 Median $1,288.25 Typical High $2,041.74 | Professional | None | $912.01 | $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 $436.52 Median $524.81 Typical High $575.44 | Professional | 52 · Reduced service | $436.52 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $208.93 Typical High $229.09 | Professional | 53 · Discontinued | $173.78 | $208.93 | $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 $131.83 Median $154.88 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $104.71 Typical High $114.82 | Professional | 56 · Pre-op care only | $87.10 | $104.71 | $114.82 |
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 7.9 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· 27th of 51
$1,380
AK $4,169TX $525
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.