How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,288 to $13,183Professionalmedian $1,318 · 10th to 90th $977 to $3,090
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 $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,258.93 | Professional | None | $891.25 | $1,071.52 | $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 $1,047.13 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,318.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,949.84 Typical High $2,630.27 | Professional | 50 · Both sides | $1,584.89 | $1,949.84 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $208.93 Typical High $281.84 | Professional | 80 · Assistant surgeon | $169.82 | $208.93 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $181.97 Typical High $245.47 | Professional | AS · PA/NP assist | $147.91 | $181.97 | $245.47 |
BCBS Kansas City Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,380.38 | Professional | None | $977.24 | $1,047.13 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $9,549.93 Typical High $13,803.84 | Facility | None | $912.01 | $9,549.93 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,187.76 | Professional | None | $891.25 | $1,148.15 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $4,365.16 Typical High $54,954.09 | Facility | None | $1,258.93 | $4,365.16 | $54,954.09 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $7,762.47 | Professional | None | $1,047.13 | $1,778.28 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $2,089.30 | Professional | None | $933.25 | $1,348.96 | $2,089.30 |
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 $446.68 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $446.68 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $177.83 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $676.08 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $89.13 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $630.96 | $758.58 | $831.76 |
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· 26th of 51
$1,380
AK $4,365TX $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.