How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,096 to $9,333Professionalmedian $1,820 · 10th to 90th $1,349 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 $2,089.30 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 $1,479.11 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,479.11 | $2,089.30 |
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 $1,445.44 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,862.09 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,818.38 Typical High $3,715.35 | Professional | 50 · Both sides | $2,187.76 | $2,818.38 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,174.90 Typical High $1,548.82 | Professional | 62 · Two surgeons | $912.01 | $1,174.90 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $302.00 Typical High $398.11 | Professional | 80 · Assistant surgeon | $234.42 | $302.00 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $263.03 Typical High $346.74 | Professional | AS · PA/NP assist | $204.17 | $263.03 | $346.74 |
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 $707.95 Median $4,570.88 Typical High $6,760.83 | Facility | None | $707.95 | $4,570.88 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $3,019.95 | Professional | None | $1,230.27 | $1,584.89 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,090.30 Typical High $12,022.64 | Facility | None | $54.95 | $3,090.30 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $2,511.89 Typical High $13,489.63 | Professional | None | $1,479.11 | $2,511.89 | $13,489.63 |
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 $1,288.25 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,862.09 | $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 $616.60 Median $741.31 Typical High $812.83 | Professional | 52 · Reduced service | $616.60 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $295.12 Typical High $323.59 | Professional | 53 · Discontinued | $245.47 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,096.48 Typical High $1,230.27 | Professional | 54 · Surgery only | $933.25 | $1,096.48 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $218.78 Typical High $245.47 | Professional | 55 · Aftercare only | $186.21 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $147.91 Typical High $162.18 | Professional | 56 · Pre-op care only | $123.03 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,023.29 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $870.96 | $1,023.29 | $1,148.15 |
Where Missouri sits
The same service costs 8.7 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· 29th of 51
$1,905
AK $5,888TX $676
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.