How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $13,490Professionalmedian $1,096 · 10th to 90th $794 to $2,455
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 $741.31 Median $870.96 Typical High $1,348.96 | Professional | None | $741.31 | $870.96 | $1,348.96 |
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 $891.25 Median $1,122.02 Typical High $1,479.11 | Professional | None | $891.25 | $1,122.02 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,659.59 Typical High $2,187.76 | Professional | 50 · Both sides | $1,318.26 | $1,659.59 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $707.95 Typical High $912.01 | Professional | 62 · Two surgeons | $549.54 | $707.95 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $177.83 Typical High $234.42 | Professional | 80 · Assistant surgeon | $141.25 | $177.83 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $154.88 Typical High $204.17 | Professional | AS · PA/NP assist | $123.03 | $154.88 | $204.17 |
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 $8,709.64 Typical High $12,882.50 | Facility | None | $645.65 | $8,709.64 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,778.28 | Professional | None | $724.44 | $933.25 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $5,011.87 Typical High $52,480.75 | Facility | None | $1,096.48 | $5,011.87 | $52,480.75 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $6,456.54 | Professional | None | $870.96 | $1,479.11 | $6,456.54 |
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 $776.25 Median $1,096.48 Typical High $1,737.80 | Professional | None | $776.25 | $1,096.48 | $1,737.80 |
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 $371.54 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $371.54 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $147.91 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $549.54 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $109.65 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $74.13 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $512.86 | $616.60 | $676.08 |
Where Missouri sits
The same service costs 7.5 times more in Alaska than in Hawaii. 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.
Physician feeFacility fee
AK $19,036HI $2,542
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.