How much rates vary
Facilitymedian $3,715 · 10th to 90th $977 to $10,471Professionalmedian $1,096 · 10th to 90th $832 to $2,630
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 $1,047.13 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,047.13 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,047.13 | Professional | None | $794.33 | $933.25 | $1,047.13 |
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 $870.96 Median $1,122.02 Typical High $1,513.56 | Professional | None | $870.96 | $1,122.02 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,698.24 Typical High $2,238.72 | Professional | 50 · Both sides | $1,318.26 | $1,698.24 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $181.97 Typical High $239.88 | Professional | 80 · Assistant surgeon | $141.25 | $181.97 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $158.49 Typical High $208.93 | Professional | AS · PA/NP assist | $123.03 | $158.49 | $208.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,202.26 | Professional | None | $851.14 | $912.01 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $9,332.54 Typical High $13,803.84 | Facility | None | $707.95 | $9,332.54 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,698.24 | Professional | None | $776.25 | $1,023.29 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,019.95 Typical High $7,585.78 | Facility | None | $54.95 | $3,019.95 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,548.82 Typical High $6,918.31 | Professional | None | $870.96 | $1,548.82 | $6,918.31 |
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 $831.76 Median $1,096.48 Typical High $1,862.09 | Professional | None | $831.76 | $1,096.48 | $1,862.09 |
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 $398.11 Median $467.74 Typical High $524.81 | Professional | 52 · Reduced service | $398.11 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $190.55 Typical High $208.93 | Professional | 53 · Discontinued | $158.49 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $707.95 Typical High $776.25 | Professional | 54 · Surgery only | $588.84 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $141.25 Typical High $154.88 | Professional | 55 · Aftercare only | $117.49 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $79.43 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $660.69 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $549.54 | $660.69 | $724.44 |
Where Missouri sits
The same service costs 16.2 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
$1,175
AK $3,802TX $234
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.