How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,175 to $10,471Professionalmedian $955 · 10th to 90th $776 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 $741.31 Median $870.96 Typical High $1,023.29 | Professional | None | $741.31 | $870.96 | $1,023.29 |
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 $912.01 Typical High $1,412.54 | Professional | None | $776.25 | $912.01 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,380.38 Typical High $2,089.30 | Professional | 50 · Both sides | $1,174.90 | $1,380.38 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $575.44 Typical High $870.96 | Professional | 62 · Two surgeons | $489.78 | $575.44 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $147.91 Typical High $218.78 | Professional | 80 · Assistant surgeon | $125.89 | $147.91 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $128.82 Typical High $194.98 | Professional | AS · PA/NP assist | $109.65 | $128.82 | $194.98 |
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 $645.65 Median $4,570.88 Typical High $6,760.83 | Facility | None | $645.65 | $4,570.88 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,698.24 | Professional | None | $724.44 | $912.01 | $1,698.24 |
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 $151.36 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $151.36 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $562.34 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $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 $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $524.81 | $616.60 | $691.83 |
Where Missouri sits
The same service costs 8.1 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· 33rd of 51
$1,000
AK $3,631TX $447
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.