How much rates vary
Facilitymedian $3,162 · 10th to 90th $955 to $7,762Professionalmedian $1,096 · 10th to 90th $794 to $2,630
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 $954.99 Median $4,897.79 Typical High $7,762.47 | Facility | None | $954.99 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $954.99 | Professional | None | $724.44 | $831.76 | $954.99 |
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 $891.25 Median $1,122.02 Typical High $1,479.11 | Professional | None | $891.25 | $1,122.02 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,659.59 Typical High $2,187.76 | Professional | 50 · Both sides | $1,318.26 | $1,659.59 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $707.95 Typical High $933.25 | Professional | 62 · Two surgeons | $562.34 | $707.95 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $177.83 Typical High $234.42 | Professional | 80 · Assistant surgeon | $141.25 | $177.83 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $154.88 Typical High $204.17 | Professional | AS · PA/NP assist | $123.03 | $154.88 | $204.17 |
BCBS Kansas City Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,148.15 | Professional | None | $758.58 | $831.76 | $1,148.15 |
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 $707.95 Median $933.25 Typical High $1,778.28 | Professional | None | $707.95 | $933.25 | $1,778.28 |
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 $891.25 Median $1,479.11 Typical High $6,165.95 | Professional | None | $891.25 | $1,479.11 | $6,165.95 |
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 $758.58 Median $1,122.02 Typical High $1,698.24 | Professional | None | $758.58 | $1,122.02 | $1,698.24 |
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 $354.81 Median $416.87 Typical High $467.74 | Professional | 52 · Reduced service | $354.81 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $144.54 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $537.03 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $107.15 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $501.19 | $575.44 | $660.69 |
Where Missouri sits
The same service costs 5.0 times more in Alabama 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
AL $11,256KY $2,261
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.