How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,202 to $10,471Professionalmedian $1,096 · 10th to 90th $891 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 $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 $891.25 Median $1,047.13 Typical High $1,621.81 | Professional | None | $891.25 | $1,047.13 | $1,621.81 |
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 $933.25 Median $1,023.29 Typical High $1,621.81 | Professional | None | $933.25 | $1,023.29 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,513.56 Typical High $2,398.83 | Professional | 50 · Both sides | $1,380.38 | $1,513.56 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $162.18 Typical High $257.04 | Professional | 80 · Assistant surgeon | $147.91 | $162.18 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $141.25 Typical High $223.87 | Professional | AS · PA/NP assist | $128.82 | $141.25 | $223.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,380.38 | Professional | None | $977.24 | $1,047.13 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,630.78 Typical High $5,370.32 | Facility | None | $758.58 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,995.26 | Professional | None | $870.96 | $1,071.52 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $3,801.89 Typical High $26,302.68 | Facility | None | $1,096.48 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $7,762.47 | Professional | None | $1,023.29 | $1,698.24 | $7,762.47 |
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 $891.25 Median $1,230.27 Typical High $2,041.74 | Professional | None | $891.25 | $1,230.27 | $2,041.74 |
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 $446.68 Median $524.81 Typical High $588.84 | Professional | 52 · Reduced service | $446.68 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $208.93 Typical High $234.42 | Professional | 53 · Discontinued | $177.83 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $776.25 Typical High $870.96 | Professional | 54 · Surgery only | $660.69 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $154.88 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $104.71 Typical High $117.49 | Professional | 56 · Pre-op care only | $89.13 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $724.44 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $616.60 | $724.44 | $812.83 |
Where Missouri sits
The same service costs 3.9 times more in Alaska than in Delaware. 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 $12,209DE $3,093
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.