How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,072 to $7,943Professionalmedian $1,259 · 10th to 90th $955 to $2,951
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 $870.96 Median $1,047.13 Typical High $1,288.25 | Professional | None | $870.96 | $1,047.13 | $1,288.25 |
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 $1,023.29 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,202.26 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $2,511.89 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,071.52 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $269.15 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $234.42 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,348.96 | Professional | None | $954.99 | $1,023.29 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,089.30 Typical High $2,691.53 | Facility | None | $707.95 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,949.84 | Professional | None | $870.96 | $1,096.48 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,019.95 Typical High $7,585.78 | Facility | None | $54.95 | $3,019.95 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $8,511.38 | Professional | None | $1,047.13 | $1,737.80 | $8,511.38 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $12,302.69 | Facility | None | $977.24 | $4,570.88 | $12,302.69 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $2,089.30 | Professional | None | $912.01 | $1,288.25 | $2,089.30 |
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 $436.52 Median $524.81 Typical High $575.44 | Professional | 52 · Reduced service | $436.52 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $208.93 Typical High $234.42 | Professional | 53 · Discontinued | $177.83 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $794.33 Typical High $870.96 | Professional | 54 · Surgery only | $660.69 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $158.49 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $104.71 Typical High $114.82 | Professional | 56 · Pre-op care only | $87.10 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $741.31 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $616.60 | $741.31 | $812.83 |
Where Missouri sits
The same service costs 18.2 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
$1,318
AK $4,266TX $234
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.