How much rates vary
Facilitymedian $3,020 · 10th to 90th $525 to $9,550Professionalmedian $5,754 · 10th to 90th $4,365 to $22,387
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 $5,623.41 Typical High $7,762.47 | Facility | None | $2,511.89 | $5,623.41 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $4,365.16 Median $4,897.79 Typical High $5,370.32 | Professional | None | $4,365.16 | $4,897.79 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,265.80 Median $5,370.32 Typical High $8,709.64 | Professional | None | $4,265.80 | $5,370.32 | $8,709.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,691.53 Median $3,388.44 Typical High $5,495.41 | Professional | 62 · Two surgeons | $2,691.53 | $3,388.44 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $691.83 Median $851.14 Typical High $1,412.54 | Professional | 80 · Assistant surgeon | $691.83 | $851.14 | $1,412.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $602.56 Median $758.58 Typical High $1,230.27 | Professional | AS · PA/NP assist | $602.56 | $758.58 | $1,230.27 |
BCBS Kansas City Setting Professional Modifier None Typical Low $4,570.88 Median $5,011.87 Typical High $7,079.46 | Professional | None | $4,570.88 | $5,011.87 | $7,079.46 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,748.98 | Facility | None | $54.95 | $1,380.38 | $11,748.98 |
Medica Setting Professional Modifier None Typical Low $5,128.61 Median $10,232.93 Typical High $154,881.66 | Professional | None | $5,128.61 | $10,232.93 | $154,881.66 |
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 $4,570.88 Median $6,918.31 Typical High $10,232.93 | Professional | None | $4,570.88 | $6,918.31 | $10,232.93 |
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 $2,187.76 Median $2,398.83 Typical High $2,630.27 | Professional | 52 · Reduced service | $2,187.76 | $2,398.83 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $977.24 Typical High $1,047.13 | Professional | 53 · Discontinued | $870.96 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,630.78 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,311.31 | $3,630.78 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $724.44 Typical High $776.25 | Professional | 55 · Aftercare only | $660.69 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $489.78 Typical High $524.81 | Professional | 56 · Pre-op care only | $436.52 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,388.44 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,388.44 | $3,630.78 |
Where Missouri sits
The same service costs 8.4 times more in Wisconsin 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.
Physician feeFacility fee
WI $28,671TX $3,407
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.