How much rates vary
Facilitymedian $2,512 · 10th to 90th $525 to $8,511Professionalmedian $1,413 · 10th to 90th $1,096 to $3,162
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 $1,380.38 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,380.38 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,148.15 | $1,445.44 |
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 $1,096.48 Median $1,258.93 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,258.93 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $794.33 Typical High $1,348.96 | Professional | 62 · Two surgeons | $691.83 | $794.33 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $204.17 Typical High $338.84 | Professional | 80 · Assistant surgeon | $173.78 | $204.17 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $302.00 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $302.00 |
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 $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 $1,071.52 Median $1,288.25 Typical High $2,951.21 | Professional | None | $1,071.52 | $1,288.25 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,258.93 Typical High $11,220.18 | Facility | None | $54.95 | $1,258.93 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $8,128.31 | Professional | None | $1,288.25 | $2,344.23 | $8,128.31 |
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 $1,174.90 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,659.59 | $2,398.83 |
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 $512.86 Median $575.44 Typical High $616.60 | Professional | 52 · Reduced service | $512.86 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $114.82 Typical High $123.03 | Professional | 56 · Pre-op care only | $104.71 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $794.33 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $794.33 | $870.96 |
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· 29th of 51
$1,445
AK $4,571TX $676
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.