How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,148 to $7,079Professionalmedian $1,514 · 10th to 90th $1,047 to $3,090
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 $1,000.00 Median $1,096.48 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,096.48 | $1,737.80 |
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 $1,148.15 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,513.56 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $954.99 Typical High $1,288.25 | Professional | 62 · Two surgeons | $724.44 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $239.88 Typical High $323.59 | Professional | 80 · Assistant surgeon | $181.97 | $239.88 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $208.93 Typical High $288.40 | Professional | AS · PA/NP assist | $158.49 | $208.93 | $288.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,445.44 | Professional | None | $933.25 | $1,023.29 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,311.31 Typical High $4,365.16 | Facility | None | $758.58 | $3,311.31 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,230.27 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $1,995.26 Typical High $13,803.84 | Facility | None | $1,047.13 | $1,995.26 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,187.76 Typical High $7,943.28 | Professional | None | $1,202.26 | $2,187.76 | $7,943.28 |
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 $1,122.02 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,548.82 | $2,344.23 |
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 $489.78 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $489.78 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $229.09 | Professional | 53 · Discontinued | $199.53 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $741.31 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $173.78 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $812.83 |
Where Missouri sits
The same service costs 4.6 times more in Alaska 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
AK $11,283KY $2,440
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.