How much rates vary
Facilitymedian $3,467 · 10th to 90th $955 to $7,762Professionalmedian $871 · 10th to 90th $661 to $1,905
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 $812.83 Median $4,897.79 Typical High $7,762.47 | Facility | None | $812.83 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $794.33 | Professional | None | $602.56 | $707.95 | $794.33 |
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 $724.44 Median $870.96 Typical High $1,202.26 | Professional | None | $724.44 | $870.96 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,288.25 Typical High $1,819.70 | Professional | 50 · Both sides | $1,071.52 | $1,288.25 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $138.04 Typical High $190.55 | Professional | 80 · Assistant surgeon | $114.82 | $138.04 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $120.23 Typical High $169.82 | Professional | AS · PA/NP assist | $100.00 | $120.23 | $169.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $933.25 | Professional | None | $660.69 | $707.95 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,630.78 Typical High $5,370.32 | Facility | None | $707.95 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,412.54 | Professional | None | $588.84 | $758.58 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,818.38 Typical High $7,585.78 | Facility | None | $54.95 | $2,818.38 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,230.27 Typical High $5,370.32 | Professional | None | $707.95 | $1,230.27 | $5,370.32 |
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 $616.60 Median $891.25 Typical High $1,412.54 | Professional | None | $616.60 | $891.25 | $1,412.54 |
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 $295.12 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $141.25 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $446.68 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $70.79 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $501.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $416.87 | $501.19 | $549.54 |
Where Missouri sits
The same service costs 8.7 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· 30th of 51
$933
AK $2,884TX $331
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.