How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,096 to $15,488Professionalmedian $1,413 · 10th to 90th $1,072 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 $2,511.89 Median $5,623.41 Typical High $14,791.08 | Facility | None | $2,511.89 | $5,623.41 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $2,344.23 | Professional | None | $954.99 | $1,148.15 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $16,982.44 | Facility | None | $1,318.26 | $3,890.45 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,412.54 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,089.30 Typical High $2,884.03 | Professional | 50 · Both sides | $1,698.24 | $2,089.30 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $891.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $707.95 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $223.87 Typical High $309.03 | Professional | 80 · Assistant surgeon | $181.97 | $223.87 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $194.98 Typical High $269.15 | Professional | AS · PA/NP assist | $158.49 | $194.98 | $269.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,122.02 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $10,715.19 Typical High $15,488.17 | Facility | None | $741.31 | $10,715.19 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,344.23 | Professional | None | $954.99 | $1,230.27 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,090.30 Typical High $10,000.00 | Facility | None | $54.95 | $3,090.30 | $10,000.00 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $1,905.46 Typical High $9,549.93 | Professional | None | $1,122.02 | $1,905.46 | $9,549.93 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,786.30 Typical High $16,595.87 | Facility | None | $977.24 | $4,786.30 | $16,595.87 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,445.44 | $2,238.72 |
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 $478.63 Median $575.44 Typical High $630.96 | Professional | 52 · Reduced service | $478.63 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $190.55 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $851.14 Typical High $954.99 | Professional | 54 · Surgery only | $724.44 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $169.82 Typical High $190.55 | Professional | 55 · Aftercare only | $144.54 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $95.50 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $794.33 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $676.08 | $794.33 | $891.25 |
Where Missouri sits
The same service costs 10.4 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 $29,118KY $2,808
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.