How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $1,413 · 10th to 90th $1,000 to $2,818
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 $1,174.90 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,174.90 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,258.93 | Professional | None | $891.25 | $1,000.00 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,412.54 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,479.11 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $933.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $630.96 | $933.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $234.42 Typical High $316.23 | Professional | 80 · Assistant surgeon | $158.49 | $234.42 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $204.17 Typical High $275.42 | Professional | AS · PA/NP assist | $138.04 | $204.17 | $275.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,479.11 | Professional | None | $954.99 | $1,071.52 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $2,570.40 | Professional | None | $933.25 | $1,122.02 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $11,220.18 | Facility | None | $54.95 | $1,230.27 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,041.74 Typical High $7,244.36 | Professional | None | $1,122.02 | $2,041.74 | $7,244.36 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,445.44 | $2,089.30 |
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 $446.68 Median $501.19 Typical High $537.03 | Professional | 52 · Reduced service | $446.68 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $213.80 | Professional | 53 · Discontinued | $181.97 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $758.58 |
Where Missouri sits
The same service costs 6.8 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· 17th of 51
$1,514
AK $3,981TX $589
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.