How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,175 to $10,233Professionalmedian $1,514 · 10th to 90th $1,230 to $3,467
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 $1,148.15 Median $1,258.93 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,258.93 | $2,511.89 |
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 $1,258.93 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,479.11 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $933.25 Typical High $1,513.56 | Professional | 62 · Two surgeons | $794.33 | $933.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $380.19 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $208.93 Typical High $331.13 | Professional | AS · PA/NP assist | $177.83 | $208.93 | $331.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,230.27 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,905.46 Typical High $3,801.89 | Facility | None | $912.01 | $1,905.46 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,445.44 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $2,754.23 Typical High $26,302.68 | Facility | None | $1,096.48 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $2,570.40 Typical High $9,332.54 | Professional | None | $1,380.38 | $2,570.40 | $9,332.54 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,819.70 | $2,691.53 |
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 $575.44 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $575.44 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $275.42 | Professional | 53 · Discontinued | $229.09 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $954.99 |
Where Missouri sits
The same service costs 3.2 times more in Alaska than in Delaware. 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 $8,931DE $2,772
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.