How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,122 to $7,244Professionalmedian $1,514 · 10th to 90th $1,096 to $3,467
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 $1,000.00 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,202.26 | $1,479.11 |
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 $1,230.27 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,548.82 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,290.87 Typical High $3,090.30 | Professional | 50 · Both sides | $1,819.70 | $2,290.87 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $954.99 Typical High $1,288.25 | Professional | 62 · Two surgeons | $776.25 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $245.47 Typical High $323.59 | Professional | 80 · Assistant surgeon | $194.98 | $245.47 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $213.80 Typical High $288.40 | Professional | AS · PA/NP assist | $169.82 | $213.80 | $288.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,148.15 | $1,548.82 |
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 $1,000.00 Median $1,288.25 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,288.25 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,511.89 Typical High $6,918.31 | Facility | None | $54.95 | $2,511.89 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,089.30 Typical High $9,549.93 | Professional | None | $1,202.26 | $2,089.30 | $9,549.93 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,513.56 | $2,344.23 |
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 $501.19 Median $602.56 Typical High $660.69 | Professional | 52 · Reduced service | $501.19 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $239.88 Typical High $263.03 | Professional | 53 · Discontinued | $199.53 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $891.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $758.58 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $177.83 Typical High $199.53 | Professional | 55 · Aftercare only | $151.36 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $120.23 Typical High $131.83 | Professional | 56 · Pre-op care only | $100.00 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $831.76 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $707.95 | $831.76 | $933.25 |
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· 28th of 51
$1,585
AK $4,786TX $550
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.