How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,122 to $11,482Professionalmedian $2,042 · 10th to 90th $1,514 to $4,677
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 $1,380.38 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,621.81 | $1,819.70 |
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 $1,621.81 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,621.81 | $2,041.74 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,288.25 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,023.29 | $1,288.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $331.13 Typical High $467.74 | Professional | 80 · Assistant surgeon | $275.42 | $331.13 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $288.40 Typical High $407.38 | Professional | AS · PA/NP assist | $229.09 | $288.40 | $407.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,584.89 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $9,120.11 Typical High $13,489.63 | Facility | None | $707.95 | $9,120.11 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,348.96 | $1,778.28 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,715.35 Typical High $23,988.33 | Facility | None | $54.95 | $3,715.35 | $23,988.33 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $2,754.23 Typical High $14,454.40 | Professional | None | $1,621.81 | $2,754.23 | $14,454.40 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $19,054.61 | Facility | None | $1,174.90 | $5,248.07 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,445.44 | $2,041.74 | $3,235.94 |
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 $691.83 Median $812.83 Typical High $912.01 | Professional | 52 · Reduced service | $691.83 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $323.59 Typical High $363.08 | Professional | 53 · Discontinued | $275.42 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,230.27 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,023.29 | $1,230.27 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $245.47 Typical High $269.15 | Professional | 55 · Aftercare only | $204.17 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $162.18 Typical High $181.97 | Professional | 56 · Pre-op care only | $138.04 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,148.15 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $954.99 | $1,148.15 | $1,258.93 |
Where Missouri sits
The same service costs 20.4 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· 28th of 51
$2,089
AK $6,607TX $324
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.