How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,072 to $10,471Professionalmedian $603 · 10th to 90th $427 to $1,349
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 $549.54 Median $3,715.35 Typical High $7,762.47 | Facility | None | $549.54 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $602.56 | Professional | None | $398.11 | $457.09 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $489.78 Median $630.96 Typical High $831.76 | Professional | None | $489.78 | $630.96 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $398.11 Typical High $524.81 | Professional | 62 · Two surgeons | $309.03 | $398.11 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $102.33 Typical High $131.83 | Professional | 80 · Assistant surgeon | $77.62 | $102.33 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $89.13 Typical High $114.82 | Professional | AS · PA/NP assist | $67.61 | $89.13 | $114.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $630.96 | Professional | None | $446.68 | $478.63 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,630.78 Typical High $5,370.32 | Facility | None | $602.56 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $1,000.00 | Professional | None | $398.11 | $512.86 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $2,754.23 Typical High $19,952.62 | Facility | None | $794.33 | $2,754.23 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $812.83 Typical High $4,466.84 | Professional | None | $478.63 | $812.83 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $954.99 | Professional | None | $426.58 | $616.60 | $954.99 |
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 $199.53 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $199.53 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $79.43 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $302.00 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $39.81 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $338.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $281.84 | $338.84 | $371.54 |
Where Missouri sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.