How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,259 to $10,715Professionalmedian $1,148 · 10th to 90th $851 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 $1,698.24 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 $776.25 Median $933.25 Typical High $1,148.15 | Professional | None | $776.25 | $933.25 | $1,148.15 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $954.99 Median $1,122.02 Typical High $1,584.89 | Professional | None | $954.99 | $1,122.02 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,698.24 Typical High $2,398.83 | Professional | 50 · Both sides | $1,445.44 | $1,698.24 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $181.97 Typical High $257.04 | Professional | 80 · Assistant surgeon | $151.36 | $181.97 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $158.49 Typical High $223.87 | Professional | AS · PA/NP assist | $134.90 | $158.49 | $223.87 |
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 $645.65 Median $6,760.83 Typical High $9,772.37 | Facility | None | $645.65 | $6,760.83 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,905.46 | Professional | None | $776.25 | $977.24 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $4,073.80 Typical High $38,018.94 | Facility | None | $1,202.26 | $4,073.80 | $38,018.94 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $1,621.81 Typical High $7,244.36 | Professional | None | $933.25 | $1,621.81 | $7,244.36 |
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 $812.83 Median $1,174.90 Typical High $1,819.70 | Professional | None | $812.83 | $1,174.90 | $1,819.70 |
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 $389.05 Median $467.74 Typical High $512.86 | Professional | 52 · Reduced service | $389.05 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $186.21 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $691.83 Typical High $776.25 | Professional | 54 · Surgery only | $588.84 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $138.04 Typical High $154.88 | Professional | 55 · Aftercare only | $117.49 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $93.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $77.62 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $645.65 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $549.54 | $645.65 | $724.44 |
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· 32nd of 51
$1,230
AK $3,715TX $468
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.