How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,259 to $12,882Professionalmedian $1,259 · 10th to 90th $933 to $3,020
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 $851.14 Median $1,023.29 Typical High $1,202.26 | Professional | None | $851.14 | $1,023.29 | $1,202.26 |
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 $1,000.00 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,288.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,905.46 Typical High $2,511.89 | Professional | 50 · Both sides | $1,513.56 | $1,905.46 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $269.15 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $177.83 Typical High $234.42 | Professional | AS · PA/NP assist | $141.25 | $177.83 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,318.26 | Professional | None | $933.25 | $1,000.00 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $6,760.83 Typical High $9,772.37 | Facility | None | $912.01 | $6,760.83 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $2,041.74 | Professional | None | $831.76 | $1,096.48 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $5,011.87 Typical High $38,018.94 | Facility | None | $1,174.90 | $5,011.87 | $38,018.94 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $7,413.10 | Professional | None | $1,000.00 | $1,698.24 | $7,413.10 |
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 $891.25 Median $1,258.93 Typical High $1,995.26 | Professional | None | $891.25 | $1,258.93 | $1,995.26 |
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 $426.58 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $426.58 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $204.17 Typical High $223.87 | Professional | 53 · Discontinued | $169.82 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $758.58 Typical High $831.76 | Professional | 54 · Surgery only | $630.96 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $151.36 Typical High $165.96 | Professional | 55 · Aftercare only | $125.89 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $102.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $85.11 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $588.84 | $707.95 | $776.25 |
Where Missouri sits
The same service costs 8.5 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
$1,318
AK $4,074TX $479
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.