How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,175 to $8,913Professionalmedian $1,072 · 10th to 90th $832 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 $794.33 Median $933.25 Typical High $1,148.15 | Professional | None | $794.33 | $933.25 | $1,148.15 |
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 $1,071.52 Typical High $1,513.56 | Professional | None | $851.14 | $1,071.52 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $676.08 Typical High $912.01 | Professional | 62 · Two surgeons | $537.03 | $676.08 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $173.78 Typical High $234.42 | Professional | 80 · Assistant surgeon | $134.90 | $173.78 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $151.36 Typical High $204.17 | Professional | AS · PA/NP assist | $120.23 | $151.36 | $204.17 |
BCBS Kansas City Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,258.93 | Professional | None | $870.96 | $954.99 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,691.53 | Facility | None | $645.65 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,778.28 | Professional | None | $776.25 | $954.99 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $26,302.68 | Facility | None | $1,047.13 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,548.82 Typical High $6,918.31 | Professional | None | $912.01 | $1,548.82 | $6,918.31 |
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 $1,096.48 Typical High $1,819.70 | Professional | None | $794.33 | $1,096.48 | $1,819.70 |
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 $398.11 Median $467.74 Typical High $524.81 | Professional | 52 · Reduced service | $398.11 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $186.21 Typical High $208.93 | Professional | 53 · Discontinued | $158.49 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $691.83 Typical High $776.25 | Professional | 54 · Surgery only | $588.84 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $138.04 Typical High $154.88 | Professional | 55 · Aftercare only | $117.49 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $79.43 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $645.65 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $549.54 | $645.65 | $724.44 |
Where Missouri sits
The same service costs 3.1 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 $8,167HI $2,648
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.