How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,259 to $12,882Professionalmedian $1,230 · 10th to 90th $912 to $2,692
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 $812.83 Median $977.24 Typical High $1,202.26 | Professional | None | $812.83 | $977.24 | $1,202.26 |
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 $1,000.00 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,862.09 Typical High $2,570.40 | Professional | 50 · Both sides | $1,513.56 | $1,862.09 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $794.33 Typical High $1,071.52 | Professional | 62 · Two surgeons | $630.96 | $794.33 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $199.53 Typical High $275.42 | Professional | 80 · Assistant surgeon | $162.18 | $199.53 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $173.78 Typical High $239.88 | Professional | AS · PA/NP assist | $141.25 | $173.78 | $239.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,258.93 | Professional | None | $891.25 | $954.99 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,897.79 Typical High $7,079.46 | Facility | None | $645.65 | $4,897.79 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,995.26 | Professional | None | $812.83 | $1,047.13 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $5,011.87 Typical High $26,302.68 | Facility | None | $1,174.90 | $5,011.87 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,698.24 Typical High $7,585.78 | Professional | None | $977.24 | $1,698.24 | $7,585.78 |
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 $851.14 Median $1,230.27 Typical High $1,949.84 | Professional | None | $851.14 | $1,230.27 | $1,949.84 |
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 $407.38 Median $489.78 Typical High $537.03 | Professional | 52 · Reduced service | $407.38 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $194.98 Typical High $213.80 | Professional | 53 · Discontinued | $165.96 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $741.31 Typical High $812.83 | Professional | 54 · Surgery only | $616.60 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $123.03 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $97.72 Typical High $107.15 | Professional | 56 · Pre-op care only | $81.28 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $691.83 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $575.44 | $691.83 | $758.58 |
Where Missouri sits
The same service costs 5.4 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 $14,696HI $2,704
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.