How much rates vary
Facilitymedian $3,090 · 10th to 90th $912 to $7,762Professionalmedian $813 · 10th to 90th $646 to $1,950
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 $831.76 Median $4,897.79 Typical High $7,762.47 | Facility | None | $831.76 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $794.33 | Professional | None | $602.56 | $724.44 | $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 $676.08 Median $794.33 Typical High $1,174.90 | Professional | None | $676.08 | $794.33 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $1,737.80 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $186.21 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $162.18 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $162.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $954.99 | Professional | None | $676.08 | $724.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,089.30 Typical High $2,691.53 | Facility | None | $707.95 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,318.26 | Professional | None | $602.56 | $741.31 | $1,318.26 |
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 $691.83 Median $1,174.90 Typical High $5,248.07 | Professional | None | $691.83 | $1,174.90 | $5,248.07 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $12,302.69 | Facility | None | $977.24 | $4,570.88 | $12,302.69 |
United Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,412.54 | Professional | None | $616.60 | $812.83 | $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 $302.00 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $562.34 |
Where Missouri sits
The same service costs 19.5 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· 27th of 51
$912
AK $2,951TX $151
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.