How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,072 to $9,120Professionalmedian $1,479 · 10th to 90th $1,096 to $3,548
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 $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,174.90 | $1,659.59 |
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 $1,174.90 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,513.56 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,238.72 Typical High $3,019.95 | Professional | 50 · Both sides | $1,737.80 | $2,238.72 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $954.99 Typical High $1,258.93 | Professional | 62 · Two surgeons | $741.31 | $954.99 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $239.88 Typical High $316.23 | Professional | 80 · Assistant surgeon | $186.21 | $239.88 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $208.93 Typical High $281.84 | Professional | AS · PA/NP assist | $162.18 | $208.93 | $281.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,148.15 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,786.30 Typical High $6,918.31 | Facility | None | $707.95 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,398.83 | Professional | None | $977.24 | $1,258.93 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,090.30 Typical High $9,549.93 | Facility | None | $54.95 | $3,090.30 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $8,511.38 | Professional | None | $1,174.90 | $1,995.26 | $8,511.38 |
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 $1,047.13 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,479.11 | $2,344.23 |
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 $489.78 Median $588.84 Typical High $645.65 | Professional | 52 · Reduced service | $489.78 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $234.42 Typical High $263.03 | Professional | 53 · Discontinued | $199.53 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $891.25 Typical High $977.24 | Professional | 54 · Surgery only | $741.31 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $177.83 Typical High $194.98 | Professional | 55 · Aftercare only | $147.91 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $117.49 Typical High $131.83 | Professional | 56 · Pre-op care only | $100.00 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $831.76 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $691.83 | $831.76 | $912.01 |
Where Missouri sits
The same service costs 5.5 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.
Physician feeFacility fee
AK $14,559TX $2,668
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.