How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $11,749Professionalmedian $2,042 · 10th to 90th $1,413 to $4,467
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 $54,954.09 | Facility | None | $1,698.24 | $5,623.41 | $54,954.09 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,621.81 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,890.45 Typical High $17,378.01 | Facility | None | $1,412.54 | $3,890.45 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,949.84 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,230.27 Typical High $1,737.80 | Professional | 62 · Two surgeons | $912.01 | $1,230.27 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $316.23 Typical High $446.68 | Professional | 80 · Assistant surgeon | $234.42 | $316.23 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $275.42 Typical High $389.05 | Professional | AS · PA/NP assist | $204.17 | $275.42 | $389.05 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,412.54 | $1,905.46 |
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 $1,288.25 Median $1,737.80 Typical High $3,981.07 | Professional | None | $1,288.25 | $1,737.80 | $3,981.07 |
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 $1,819.70 Median $3,548.13 Typical High $12,589.25 | Professional | None | $1,819.70 | $3,548.13 | $12,589.25 |
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 $1,548.82 Median $2,344.23 Typical High $4,073.80 | Professional | None | $1,548.82 | $2,344.23 | $4,073.80 |
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 $707.95 Median $812.83 Typical High $870.96 | Professional | 52 · Reduced service | $707.95 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $323.59 Typical High $346.74 | Professional | 53 · Discontinued | $281.84 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,230.27 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,230.27 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $245.47 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $162.18 Typical High $173.78 | Professional | 56 · Pre-op care only | $141.25 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,148.15 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,148.15 | $1,230.27 |
Where Missouri sits
The same service costs 5.4 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· 18th of 51
$2,042
AK $5,370TX $1,000
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.