How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $8,710Professionalmedian $3,631 · 10th to 90th $2,630 to $8,511
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 $2,511.89 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,511.89 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $3,019.95 Typical High $3,890.45 | Professional | None | $2,754.23 | $3,019.95 | $3,890.45 |
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 $2,630.27 Median $3,311.31 Typical High $5,370.32 | Professional | None | $2,630.27 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $2,089.30 Typical High $3,388.44 | Professional | 62 · Two surgeons | $1,659.59 | $2,089.30 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $524.81 Typical High $851.14 | Professional | 80 · Assistant surgeon | $416.87 | $524.81 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $457.09 Typical High $758.58 | Professional | AS · PA/NP assist | $363.08 | $457.09 | $758.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,884.03 Median $3,162.28 Typical High $4,466.84 | Professional | None | $2,884.03 | $3,162.28 | $4,466.84 |
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 $2,884.03 Median $3,388.44 Typical High $8,128.31 | Professional | None | $2,884.03 | $3,388.44 | $8,128.31 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,220.18 | Facility | None | $54.95 | $1,380.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $3,467.37 Median $6,456.54 Typical High $21,379.62 | Professional | None | $3,467.37 | $6,456.54 | $21,379.62 |
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 $3,162.28 Median $4,466.84 Typical High $6,456.54 | Professional | None | $3,162.28 | $4,466.84 | $6,456.54 |
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 $1,380.38 Median $1,513.56 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,380.38 | $1,513.56 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $602.56 Typical High $660.69 | Professional | 53 · Discontinued | $549.54 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,290.87 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,089.30 | $2,290.87 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $457.09 Typical High $489.78 | Professional | 55 · Aftercare only | $416.87 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $302.00 Typical High $331.13 | Professional | 56 · Pre-op care only | $275.42 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,137.96 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,137.96 | $2,290.87 |
Where Missouri sits
The same service costs 12.6 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
$3,467
AK $12,023TX $955
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.