How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,047 to $8,511Professionalmedian $1,995 · 10th to 90th $1,479 to $4,365
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 $1,778.28 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,778.28 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,621.81 | $1,995.26 |
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 $1,584.89 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $3,019.95 Typical High $4,073.80 | Professional | 50 · Both sides | $2,398.83 | $3,019.95 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,258.93 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,000.00 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $323.59 Typical High $426.58 | Professional | 80 · Assistant surgeon | $257.04 | $323.59 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $281.84 Typical High $380.19 | Professional | AS · PA/NP assist | $223.87 | $281.84 | $380.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,548.82 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $6,760.83 Typical High $10,000.00 | Facility | None | $707.95 | $6,760.83 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $3,311.31 | Professional | None | $1,318.26 | $1,737.80 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,041.74 Typical High $7,413.10 | Facility | None | $54.95 | $2,041.74 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $11,748.98 | Professional | None | $1,621.81 | $2,630.27 | $11,748.98 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,412.54 | $2,041.74 | $3,162.28 |
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 $676.08 Median $794.33 Typical High $891.25 | Professional | 52 · Reduced service | $676.08 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $323.59 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,202.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,000.00 | $1,202.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $239.88 Typical High $263.03 | Professional | 55 · Aftercare only | $199.53 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $162.18 Typical High $177.83 | Professional | 56 · Pre-op care only | $134.90 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,122.02 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $933.25 | $1,122.02 | $1,230.27 |
Where Missouri sits
The same service costs 6.3 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.
Physician feeFacility fee
AK $16,928TX $2,675
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.