How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,259 to $11,482Professionalmedian $1,349 · 10th to 90th $1,000 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 $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 $912.01 Median $1,071.52 Typical High $1,659.59 | Professional | None | $912.01 | $1,071.52 | $1,659.59 |
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 $1,071.52 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,041.74 Typical High $2,691.53 | Professional | 50 · Both sides | $1,584.89 | $2,041.74 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $851.14 Typical High $1,122.02 | Professional | 62 · Two surgeons | $676.08 | $851.14 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $213.80 Typical High $288.40 | Professional | 80 · Assistant surgeon | $169.82 | $213.80 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $190.55 Typical High $251.19 | Professional | AS · PA/NP assist | $147.91 | $190.55 | $251.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,445.44 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $11,748.98 Typical High $15,488.17 | Facility | None | $707.95 | $11,748.98 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,187.76 | Professional | None | $891.25 | $1,148.15 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $2,951.21 Typical High $7,585.78 | Facility | None | $1,174.90 | $2,951.21 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $1,819.70 Typical High $9,120.11 | Professional | None | $1,071.52 | $1,819.70 | $9,120.11 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $2,137.96 | Professional | None | $954.99 | $1,348.96 | $2,137.96 |
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 $457.09 Median $537.03 Typical High $602.56 | Professional | 52 · Reduced service | $457.09 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $218.78 Typical High $239.88 | Professional | 53 · Discontinued | $181.97 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $676.08 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $107.15 Typical High $120.23 | Professional | 56 · Pre-op care only | $91.20 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $630.96 | $758.58 | $831.76 |
Where Missouri sits
The same service costs 6.0 times more in Alaska than in Kentucky. 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 $15,585KY $2,601
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.