How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,349 to $10,715Professionalmedian $1,514 · 10th to 90th $1,230 to $3,631
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 $1,174.90 Median $1,288.25 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,288.25 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,348.96 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,513.56 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $954.99 Typical High $1,513.56 | Professional | 62 · Two surgeons | $776.25 | $954.99 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $245.47 Typical High $389.05 | Professional | 80 · Assistant surgeon | $194.98 | $245.47 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $213.80 Typical High $338.84 | Professional | AS · PA/NP assist | $173.78 | $213.80 | $338.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,258.93 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,630.78 Typical High $4,365.16 | Facility | None | $912.01 | $3,630.78 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,412.54 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,380.38 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,570.40 Typical High $9,549.93 | Professional | None | $1,348.96 | $2,570.40 | $9,549.93 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,778.28 | $2,754.23 |
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 $588.84 Median $645.65 Typical High $660.69 | Professional | 52 · Reduced service | $588.84 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $891.25 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $933.25 |
Where Missouri sits
The same service costs 6.6 times more in Alaska than in Texas. 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· 30th of 51
$1,738
AK $5,248TX $794
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.