How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,175 to $8,913Professionalmedian $1,047 · 10th to 90th $794 to $2,512
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 $724.44 Median $870.96 Typical High $1,023.29 | Professional | None | $724.44 | $870.96 | $1,023.29 |
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 $851.14 Median $1,047.13 Typical High $1,412.54 | Professional | None | $851.14 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,584.89 Typical High $2,089.30 | Professional | 50 · Both sides | $1,258.93 | $1,584.89 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $660.69 Typical High $891.25 | Professional | 62 · Two surgeons | $537.03 | $660.69 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $169.82 Typical High $223.87 | Professional | 80 · Assistant surgeon | $134.90 | $169.82 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $147.91 Typical High $194.98 | Professional | AS · PA/NP assist | $117.49 | $147.91 | $194.98 |
BCBS Kansas City Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,122.02 | Professional | None | $794.33 | $851.14 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,511.89 Typical High $3,019.95 | Facility | None | $645.65 | $2,511.89 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,737.80 | Professional | None | $707.95 | $912.01 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $3,801.89 Typical High $26,302.68 | Facility | None | $1,071.52 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,445.44 Typical High $6,309.57 | Professional | None | $851.14 | $1,445.44 | $6,309.57 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,698.24 | Professional | None | $758.58 | $1,071.52 | $1,698.24 |
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 $363.08 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $363.08 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $144.54 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $537.03 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $501.19 | $602.56 | $660.69 |
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
$1,122
AK $3,467TX $437
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.