How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,072 to $8,913Professionalmedian $1,380 · 10th to 90th $1,023 to $3,236
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 $954.99 Median $1,122.02 Typical High $1,348.96 | Professional | None | $954.99 | $1,122.02 | $1,348.96 |
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 $1,096.48 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,380.38 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,089.30 Typical High $2,754.23 | Professional | 50 · Both sides | $1,621.81 | $2,089.30 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $223.87 Typical High $295.12 | Professional | 80 · Assistant surgeon | $173.78 | $223.87 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $194.98 Typical High $257.04 | Professional | AS · PA/NP assist | $151.36 | $194.98 | $257.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,096.48 | $1,445.44 |
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 $933.25 Median $1,174.90 Typical High $2,137.96 | Professional | None | $933.25 | $1,174.90 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,090.30 Typical High $9,120.11 | Facility | None | $54.95 | $3,090.30 | $9,120.11 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $1,905.46 Typical High $8,511.38 | Professional | None | $1,122.02 | $1,905.46 | $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 $1,000.00 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,412.54 | $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 $562.34 Typical High $630.96 | Professional | 52 · Reduced service | $478.63 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $223.87 Typical High $251.19 | Professional | 53 · Discontinued | $190.55 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $851.14 Typical High $933.25 | Professional | 54 · Surgery only | $707.95 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $169.82 Typical High $186.21 | Professional | 55 · Aftercare only | $141.25 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $112.20 Typical High $125.89 | Professional | 56 · Pre-op care only | $95.50 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $794.33 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $660.69 | $794.33 | $870.96 |
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· 31st of 51
$1,413
AK $4,571TX $525
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.