How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,175 to $8,913Professionalmedian $1,000 · 10th to 90th $794 to $6,457
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 $741.31 Median $870.96 Typical High $1,071.52 | Professional | None | $741.31 | $870.96 | $1,071.52 |
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 $831.76 Median $1,000.00 Typical High $1,412.54 | Professional | None | $831.76 | $1,000.00 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $630.96 Typical High $891.25 | Professional | 62 · Two surgeons | $524.81 | $630.96 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $229.09 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $141.25 Typical High $199.53 | Professional | AS · PA/NP assist | $117.49 | $141.25 | $199.53 |
BCBS Kansas City Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,174.90 | Professional | None | $812.83 | $870.96 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $3,715.35 Typical High $26,302.68 | Facility | None | $1,000.00 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,445.44 Typical High $6,456.54 | Professional | None | $851.14 | $1,445.44 | $6,456.54 |
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 $758.58 Median $1,047.13 Typical High $1,737.80 | Professional | None | $758.58 | $1,047.13 | $1,737.80 |
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 $371.54 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $371.54 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $147.91 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $741.31 | Professional | 54 · Surgery only | $562.34 | $645.65 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $147.91 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $74.13 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $691.83 |
Where Missouri sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.