How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,148 to $10,471Professionalmedian $794 · 10th to 90th $603 to $2,570
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 $549.54 Median $660.69 Typical High $1,000.00 | Professional | None | $549.54 | $660.69 | $1,000.00 |
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 $645.65 Median $812.83 Typical High $1,096.48 | Professional | None | $645.65 | $812.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,230.27 Typical High $1,621.81 | Professional | 50 · Both sides | $977.24 | $1,230.27 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $512.86 Typical High $660.69 | Professional | 62 · Two surgeons | $407.38 | $512.86 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $131.83 Typical High $173.78 | Professional | 80 · Assistant surgeon | $102.33 | $131.83 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $114.82 Typical High $151.36 | Professional | AS · PA/NP assist | $91.20 | $114.82 | $151.36 |
BCBS Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $851.14 | Professional | None | $602.56 | $645.65 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,370.32 Typical High $7,943.28 | Facility | None | $758.58 | $5,370.32 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,318.26 | Professional | None | $549.54 | $691.83 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $3,715.35 Typical High $26,302.68 | Facility | None | $851.14 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $4,786.30 | Professional | None | $645.65 | $1,096.48 | $4,786.30 |
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 $575.44 Median $812.83 Typical High $1,288.25 | Professional | None | $575.44 | $812.83 | $1,288.25 |
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 $275.42 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $275.42 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $109.65 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $407.38 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $97.72 Typical High $109.65 | Professional | 55 · Aftercare only | $83.18 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $380.19 | $457.09 | $501.19 |
Where Missouri sits
The same service costs 5.4 times more in Alaska than in Montana. 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 $11,142MT $2,070
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.