How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,175 to $12,882Professionalmedian $891 · 10th to 90th $676 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 $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 $616.60 Median $724.44 Typical High $851.14 | Professional | None | $616.60 | $724.44 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $6,606.93 | Facility | None | $1,288.25 | $3,467.37 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,202.26 | Professional | None | $724.44 | $912.01 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,380.38 Typical High $1,778.28 | Professional | 50 · Both sides | $1,096.48 | $1,380.38 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $147.91 Typical High $190.55 | Professional | 80 · Assistant surgeon | $117.49 | $147.91 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $128.82 Typical High $169.82 | Professional | AS · PA/NP assist | $102.33 | $128.82 | $169.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $954.99 | Professional | None | $676.08 | $724.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,630.78 Typical High $5,370.32 | Facility | None | $645.65 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,445.44 | Professional | None | $602.56 | $776.25 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $5,011.87 Typical High $26,302.68 | Facility | None | $954.99 | $5,011.87 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,202.26 Typical High $5,370.32 | Professional | None | $724.44 | $1,202.26 | $5,370.32 |
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 $630.96 Median $912.01 Typical High $1,445.44 | Professional | None | $630.96 | $912.01 | $1,445.44 |
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 $302.00 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $162.18 | Professional | 53 · Discontinued | $123.03 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $512.86 | $562.34 |
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
$955
AK $2,951TX $380
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.