How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,175 to $14,125Professionalmedian $759 · 10th to 90th $550 to $1,585
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 $512.86 Median $602.56 Typical High $676.08 | Professional | None | $512.86 | $602.56 | $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 $588.84 Median $776.25 Typical High $1,071.52 | Professional | None | $588.84 | $776.25 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,174.90 Typical High $1,584.89 | Professional | 50 · Both sides | $891.25 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $489.78 Typical High $676.08 | Professional | 62 · Two surgeons | $371.54 | $489.78 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $125.89 Typical High $169.82 | Professional | 80 · Assistant surgeon | $95.50 | $125.89 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $109.65 Typical High $147.91 | Professional | AS · PA/NP assist | $83.18 | $109.65 | $147.91 |
BCBS Kansas City Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $812.83 | Professional | None | $575.44 | $616.60 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $9,332.54 Typical High $13,803.84 | Facility | None | $758.58 | $9,332.54 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,288.25 | Professional | None | $512.86 | $660.69 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $5,011.87 Typical High $47,863.01 | Facility | None | $891.25 | $5,011.87 | $47,863.01 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,071.52 Typical High $4,570.88 | Professional | None | $616.60 | $1,071.52 | $4,570.88 |
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 $537.03 Median $776.25 Typical High $1,230.27 | Professional | None | $537.03 | $776.25 | $1,230.27 |
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 $257.04 Median $309.03 Typical High $338.84 | Professional | 52 · Reduced service | $257.04 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $102.33 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $389.05 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $61.66 Typical High $67.61 | Professional | 56 · Pre-op care only | $51.29 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $478.63 |
Where Missouri sits
The same service costs 10.1 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 $19,890MT $1,977
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.