How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,288 to $10,471Professionalmedian $3,090 · 10th to 90th $257 to $6,761
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 $2,290.87 Median $5,623.41 Typical High $12,022.64 | Facility | None | $2,290.87 | $5,623.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $2,884.03 Typical High $3,548.13 | Professional | None | $234.42 | $2,884.03 | $3,548.13 |
Ambetter Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,445.44 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $1,023.29 Typical High $5,128.61 | Professional | None | $257.04 | $1,023.29 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $1,513.56 Typical High $7,762.47 | Professional | 50 · Both sides | $380.19 | $1,513.56 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $169.82 Typical High $812.83 | Professional | 80 · Assistant surgeon | $40.74 | $169.82 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $407.38 Typical High $724.44 | Professional | AS · PA/NP assist | $37.15 | $407.38 | $724.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $223.87 Median $2,884.03 Typical High $4,168.69 | Professional | None | $223.87 | $2,884.03 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $12,589.25 | Facility | None | $851.14 | $3,388.44 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $660.69 Typical High $6,606.93 | Professional | None | $251.19 | $660.69 | $6,606.93 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $3,548.13 Typical High $7,079.46 | Facility | None | $891.25 | $3,548.13 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $4,073.80 Median $11,220.18 Typical High $22,908.68 | Professional | None | $4,073.80 | $11,220.18 | $22,908.68 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,548.13 Typical High $7,585.78 | Facility | None | $1,000.00 | $3,548.13 | $7,585.78 |
United Setting Professional Modifier None Typical Low $302.00 Median $2,754.23 Typical High $6,606.93 | Professional | None | $302.00 | $2,754.23 | $6,606.93 |
5 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 $117.49 Median $275.42 Typical High $1,548.82 | Professional | 52 · Reduced service | $117.49 | $275.42 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $112.20 Typical High $616.60 | Professional | 53 · Discontinued | $46.77 | $112.20 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $416.87 Typical High $2,344.23 | Professional | 54 · Surgery only | $177.83 | $416.87 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $83.18 Typical High $467.74 | Professional | 55 · Aftercare only | $35.48 | $83.18 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $56.23 Typical High $309.03 | Professional | 56 · Pre-op care only | $23.44 | $56.23 | $309.03 |
Where Missouri sits
The same service costs 10.2 times more in Alaska than in Nebraska. 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· 17th of 51
$3,236
AK $5,012NE $490
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.