How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,148 to $8,913Professionalmedian $871 · 10th to 90th $661 to $2,188
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 $602.56 Median $724.44 Typical High $891.25 | Professional | None | $602.56 | $724.44 | $891.25 |
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 $707.95 Median $851.14 Typical High $1,174.90 | Professional | None | $707.95 | $851.14 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $537.03 Typical High $741.31 | Professional | 62 · Two surgeons | $446.68 | $537.03 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $186.21 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $162.18 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $162.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $954.99 | Professional | None | $660.69 | $724.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,691.53 | Facility | None | $645.65 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,445.44 | Professional | None | $602.56 | $758.58 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $3,715.35 Typical High $26,302.68 | Facility | None | $891.25 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $5,248.07 | Professional | None | $707.95 | $1,202.26 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,412.54 | Professional | None | $630.96 | $891.25 | $1,412.54 |
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 $302.00 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $512.86 | $562.34 |
Where Missouri sits
The same service costs 8.5 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.
Missouri· 29th of 51
$933
AK $2,951TX $347
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.