How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,175 to $8,913Professionalmedian $977 · 10th to 90th $759 to $2,291
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 $691.83 Median $812.83 Typical High $1,023.29 | Professional | None | $691.83 | $812.83 | $1,023.29 |
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 $794.33 Median $954.99 Typical High $1,348.96 | Professional | None | $794.33 | $954.99 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,412.54 Typical High $1,995.26 | Professional | 50 · Both sides | $1,202.26 | $1,412.54 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $602.56 Typical High $870.96 | Professional | 62 · Two surgeons | $501.19 | $602.56 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $151.36 Typical High $213.80 | Professional | 80 · Assistant surgeon | $128.82 | $151.36 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $131.83 Typical High $186.21 | Professional | AS · PA/NP assist | $112.20 | $131.83 | $186.21 |
BCBS Kansas City Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,071.52 | Professional | None | $758.58 | $812.83 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,089.30 Typical High $3,311.31 | Facility | None | $758.58 | $2,089.30 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,659.59 | Professional | None | $676.08 | $870.96 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $3,801.89 Typical High $26,302.68 | Facility | None | $977.24 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,348.96 Typical High $6,025.60 | Professional | None | $794.33 | $1,348.96 | $6,025.60 |
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 $724.44 Median $1,023.29 Typical High $1,621.81 | Professional | None | $724.44 | $1,023.29 | $1,621.81 |
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 $346.74 Median $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $346.74 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $162.18 Typical High $181.97 | Professional | 53 · Discontinued | $138.04 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $676.08 | Professional | 54 · Surgery only | $512.86 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $123.03 Typical High $134.90 | Professional | 55 · Aftercare only | $102.33 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $81.28 Typical High $91.20 | Professional | 56 · Pre-op care only | $69.18 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $575.44 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $478.63 | $575.44 | $630.96 |
Where Missouri sits
The same service costs 3.1 times more in Wisconsin than in Maryland. 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
WI $8,115MD $2,591
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.