How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,047 to $9,772Professionalmedian $1,380 · 10th to 90th $1,047 to $3,162
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 $1,258.93 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,258.93 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,258.93 | Professional | None | $954.99 | $1,148.15 | $1,258.93 |
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 $1,122.02 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,412.54 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,137.96 Typical High $2,818.38 | Professional | 50 · Both sides | $1,698.24 | $2,137.96 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $891.25 Typical High $1,174.90 | Professional | 62 · Two surgeons | $707.95 | $891.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $223.87 Typical High $302.00 | Professional | 80 · Assistant surgeon | $177.83 | $223.87 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $199.53 Typical High $263.03 | Professional | AS · PA/NP assist | $158.49 | $199.53 | $263.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,096.48 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $6,760.83 Typical High $9,772.37 | Facility | None | $707.95 | $6,760.83 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $2,290.87 | Professional | None | $933.25 | $1,230.27 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,019.95 Typical High $12,882.50 | Facility | None | $54.95 | $3,019.95 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $1,905.46 Typical High $8,317.64 | Professional | None | $1,122.02 | $1,905.46 | $8,317.64 |
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 $1,000.00 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,412.54 | $2,238.72 |
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 $478.63 Median $562.34 Typical High $630.96 | Professional | 52 · Reduced service | $478.63 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $190.55 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $851.14 Typical High $933.25 | Professional | 54 · Surgery only | $707.95 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $169.82 Typical High $186.21 | Professional | 55 · Aftercare only | $141.25 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $95.50 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $794.33 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $660.69 | $794.33 | $870.96 |
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· 28th of 51
$1,445
AK $4,571TX $550
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.