How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $13,490Professionalmedian $1,096 · 10th to 90th $832 to $3,090
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 $741.31 Median $912.01 Typical High $1,380.38 | Professional | None | $741.31 | $912.01 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $977.24 Typical High $1,096.48 | Professional | None | $147.91 | $977.24 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,585.78 | Facility | None | $1,318.26 | $3,467.37 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,513.56 | Professional | None | $891.25 | $1,096.48 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,659.59 Typical High $2,238.72 | Professional | 50 · Both sides | $1,318.26 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $691.83 Typical High $933.25 | Professional | 62 · Two surgeons | $562.34 | $691.83 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $177.83 Typical High $239.88 | Professional | 80 · Assistant surgeon | $141.25 | $177.83 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $154.88 Typical High $213.80 | Professional | AS · PA/NP assist | $123.03 | $154.88 | $213.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,174.90 | Professional | None | $831.76 | $891.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $8,709.64 Typical High $12,882.50 | Facility | None | $758.58 | $8,709.64 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,819.70 | Professional | None | $758.58 | $954.99 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $5,011.87 Typical High $50,118.72 | Facility | None | $1,122.02 | $5,011.87 | $50,118.72 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,513.56 Typical High $6,606.93 | Professional | None | $891.25 | $1,513.56 | $6,606.93 |
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 $794.33 Median $1,122.02 Typical High $1,778.28 | Professional | None | $794.33 | $1,122.02 | $1,778.28 |
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 $380.19 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $380.19 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $181.97 Typical High $199.53 | Professional | 53 · Discontinued | $151.36 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $676.08 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $75.86 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $707.95 |
Where Missouri sits
The same service costs 6.8 times more in Alaska 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
AK $19,480MT $2,858
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.