How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,175 to $8,913Professionalmedian $933 · 10th to 90th $741 to $2,291
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 $724.44 Median $831.76 Typical High $1,000.00 | Professional | None | $724.44 | $831.76 | $1,000.00 |
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 $776.25 Median $933.25 Typical High $1,348.96 | Professional | None | $776.25 | $933.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $588.84 Typical High $831.76 | Professional | 62 · Two surgeons | $489.78 | $588.84 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $147.91 Typical High $213.80 | Professional | 80 · Assistant surgeon | $123.03 | $147.91 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $131.83 Typical High $186.21 | Professional | AS · PA/NP assist | $107.15 | $131.83 | $186.21 |
BCBS Kansas City Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,148.15 | Professional | None | $794.33 | $870.96 | $1,148.15 |
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 $707.95 Median $870.96 Typical High $1,621.81 | Professional | None | $707.95 | $870.96 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,715.35 Typical High $26,302.68 | Facility | None | $933.25 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,380.38 Typical High $6,309.57 | Professional | None | $812.83 | $1,380.38 | $6,309.57 |
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 $724.44 Median $1,000.00 Typical High $1,659.59 | Professional | None | $724.44 | $1,000.00 | $1,659.59 |
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 $363.08 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $363.08 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $144.54 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $537.03 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $107.15 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $501.19 | $588.84 | $660.69 |
Where Missouri sits
The same service costs 7.4 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· 36th of 51
$955
AK $3,467TX $468
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.