How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,096 to $10,233Professionalmedian $832 · 10th to 90th $646 to $1,995
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 $588.84 Median $707.95 Typical High $831.76 | Professional | None | $588.84 | $707.95 | $831.76 |
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 $691.83 Median $831.76 Typical High $1,122.02 | Professional | None | $691.83 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,258.93 Typical High $1,698.24 | Professional | 50 · Both sides | $1,047.13 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $131.83 Typical High $181.97 | Professional | 80 · Assistant surgeon | $109.65 | $131.83 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $158.49 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $158.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $912.01 | Professional | None | $645.65 | $707.95 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,570.40 Typical High $3,090.30 | Facility | None | $645.65 | $2,570.40 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,445.44 | Professional | None | $588.84 | $758.58 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $2,754.23 Typical High $26,302.68 | Facility | None | $851.14 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $5,754.40 | Professional | None | $676.08 | $1,174.90 | $5,754.40 |
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 $616.60 Median $851.14 Typical High $1,380.38 | Professional | None | $616.60 | $851.14 | $1,380.38 |
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 $295.12 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $446.68 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $501.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $416.87 | $501.19 | $549.54 |
Where Missouri sits
The same service costs 8.5 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
$912
AK $2,884TX $339
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.