How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,175 to $8,913Professionalmedian $1,000 · 10th to 90th $794 to $2,512
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 $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,122.02 | Professional | None | $758.58 | $912.01 | $1,122.02 |
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 $851.14 Median $933.25 Typical High $1,479.11 | Professional | None | $851.14 | $933.25 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $151.36 Typical High $234.42 | Professional | 80 · Assistant surgeon | $134.90 | $151.36 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $131.83 Typical High $204.17 | Professional | AS · PA/NP assist | $117.49 | $131.83 | $204.17 |
BCBS Kansas City Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,202.26 | Professional | None | $831.76 | $912.01 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,089.30 Typical High $3,311.31 | Facility | None | $758.58 | $2,089.30 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,737.80 | Professional | None | $741.31 | $954.99 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $3,715.35 Typical High $26,302.68 | Facility | None | $1,023.29 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,548.82 Typical High $6,760.83 | Professional | None | $891.25 | $1,548.82 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,778.28 | Professional | None | $794.33 | $1,071.52 | $1,778.28 |
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 $380.19 Median $446.68 Typical High $501.19 | Professional | 52 · Reduced service | $380.19 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $181.97 Typical High $199.53 | Professional | 53 · Discontinued | $151.36 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $676.08 Typical High $741.31 | Professional | 54 · Surgery only | $562.34 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $75.86 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $630.96 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $524.81 | $630.96 | $691.83 |
Where Missouri sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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
WI $7,993MD $2,690
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.