How much rates vary
Facilitymedian $2,818 · 10th to 90th $550 to $19,498Professionalmedian $2,455 · 10th to 90th $1,698 to $7,079
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 $1,905.46 Median $5,623.41 Typical High $54,954.09 | Facility | None | $1,905.46 | $5,623.41 | $54,954.09 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,698.24 | $1,949.84 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $4,897.79 Typical High $38,904.51 | Facility | None | $1,479.11 | $4,897.79 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $3,311.31 | Professional | None | $1,698.24 | $2,398.83 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,513.56 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,071.52 | $1,513.56 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $389.05 Typical High $537.03 | Professional | 80 · Assistant surgeon | $275.42 | $389.05 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $338.84 Typical High $467.74 | Professional | AS · PA/NP assist | $239.88 | $338.84 | $467.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,659.59 | $2,238.72 |
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 $1,548.82 Median $2,041.74 Typical High $4,677.35 | Professional | None | $1,548.82 | $2,041.74 | $4,677.35 |
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 $2,187.76 Median $4,265.80 Typical High $12,302.69 | Professional | None | $2,187.76 | $4,265.80 | $12,302.69 |
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 $1,819.70 Median $2,818.38 Typical High $4,897.79 | Professional | None | $1,819.70 | $2,818.38 | $4,897.79 |
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 $851.14 Median $977.24 Typical High $1,047.13 | Professional | 52 · Reduced service | $851.14 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $389.05 Typical High $416.87 | Professional | 53 · Discontinued | $338.84 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,479.11 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,258.93 | $1,479.11 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $295.12 Typical High $316.23 | Professional | 55 · Aftercare only | $251.19 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $194.98 Typical High $208.93 | Professional | 56 · Pre-op care only | $169.82 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,380.38 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,380.38 | $1,479.11 |
Where Missouri sits
The same service costs 5.5 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· 16th of 51
$2,455
AK $6,457TX $1,175
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.