How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,096 to $8,913Professionalmedian $2,239 · 10th to 90th $1,349 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 $2,290.87 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,290.87 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,737.80 | $2,041.74 | $2,511.89 |
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 $1,348.96 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,995.26 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $3,019.95 Typical High $4,466.84 | Professional | 50 · Both sides | $1,995.26 | $3,019.95 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,258.93 Typical High $1,905.46 | Professional | 62 · Two surgeons | $851.14 | $1,258.93 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $316.23 Typical High $478.63 | Professional | 80 · Assistant surgeon | $213.80 | $316.23 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $281.84 Typical High $416.87 | Professional | AS · PA/NP assist | $186.21 | $281.84 | $416.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,862.09 | $1,995.26 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,630.78 Typical High $5,370.32 | Facility | None | $707.95 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $3,890.45 | Professional | None | $1,348.96 | $2,238.72 | $3,890.45 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,162.28 Typical High $15,488.17 | Facility | None | $54.95 | $3,162.28 | $15,488.17 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $3,388.44 Typical High $15,135.61 | Professional | None | $1,819.70 | $3,388.44 | $15,135.61 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $4,073.80 | Professional | None | $1,737.80 | $2,511.89 | $4,073.80 |
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 $870.96 Median $1,023.29 Typical High $1,148.15 | Professional | 52 · Reduced service | $870.96 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $416.87 Typical High $457.09 | Professional | 53 · Discontinued | $346.74 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,548.82 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,288.25 | $1,548.82 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $309.03 Typical High $338.84 | Professional | 55 · Aftercare only | $257.04 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $204.17 Typical High $229.09 | Professional | 56 · Pre-op care only | $173.78 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,445.44 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,445.44 | $1,584.89 |
Where Missouri sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $18,090KY $3,723
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.