How much rates vary
Facilitymedian $2,512 · 10th to 90th $525 to $8,511Professionalmedian $2,042 · 10th to 90th $1,549 to $5,012
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 $1,778.28 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,778.28 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,621.81 | $1,862.09 | $2,511.89 |
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 $1,584.89 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,584.89 | $1,949.84 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $309.03 Typical High $512.86 | Professional | 80 · Assistant surgeon | $251.19 | $309.03 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $269.15 Typical High $446.68 | Professional | AS · PA/NP assist | $218.78 | $269.15 | $446.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,621.81 | $2,137.96 |
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 $1,479.11 Median $1,949.84 Typical High $4,466.84 | Professional | None | $1,479.11 | $1,949.84 | $4,466.84 |
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 $2,041.74 Median $4,073.80 Typical High $12,022.64 | Professional | None | $2,041.74 | $4,073.80 | $12,022.64 |
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 $1,698.24 Median $2,691.53 Typical High $4,677.35 | Professional | None | $1,698.24 | $2,691.53 | $4,677.35 |
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 $812.83 Median $933.25 Typical High $1,000.00 | Professional | 52 · Reduced service | $812.83 | $933.25 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $371.54 Typical High $398.11 | Professional | 53 · Discontinued | $323.59 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,412.54 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,202.26 | $1,412.54 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $281.84 Typical High $302.00 | Professional | 55 · Aftercare only | $239.88 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $186.21 Typical High $199.53 | Professional | 56 · Pre-op care only | $162.18 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,318.26 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,318.26 | $1,380.38 |
Where Missouri sits
The same service costs 5.6 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· 26th of 51
$2,138
AK $6,166TX $1,096
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.