How much rates vary
Facilitymedian $2,512 · 10th to 90th $832 to $7,079Professionalmedian $1,660 · 10th to 90th $1,318 to $5,129
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 $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,445.44 | $1,778.28 |
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 $1,318.26 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,737.80 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $275.42 Typical High $371.54 | Professional | 80 · Assistant surgeon | $213.80 | $275.42 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $239.88 Typical High $316.23 | Professional | AS · PA/NP assist | $186.21 | $239.88 | $316.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,412.54 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $3,801.89 | Facility | None | $831.76 | $1,148.15 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,513.56 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,949.84 Typical High $26,302.68 | Facility | None | $645.65 | $1,949.84 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $2,344.23 Typical High $10,471.29 | Professional | None | $1,380.38 | $2,344.23 | $10,471.29 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,258.93 | $1,659.59 | $2,884.03 |
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 $602.56 Median $724.44 Typical High $794.33 | Professional | 52 · Reduced service | $602.56 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $288.40 Typical High $323.59 | Professional | 53 · Discontinued | $245.47 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,202.26 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $239.88 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $144.54 Typical High $162.18 | Professional | 56 · Pre-op care only | $123.03 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,000.00 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,122.02 |
Where Missouri sits
The same service costs 17.0 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· 26th of 51
$1,698
AK $5,888TX $347
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.