How much rates vary
Facilitymedian $2,630 · 10th to 90th $501 to $7,943Professionalmedian $2,399 · 10th to 90th $1,820 to $5,623
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 $1,995.26 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,995.26 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $2,511.89 | Professional | None | $1,995.26 | $2,290.87 | $2,511.89 |
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 $1,819.70 Median $2,137.96 Typical High $3,890.45 | Professional | None | $1,819.70 | $2,137.96 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $338.84 Typical High $630.96 | Professional | 80 · Assistant surgeon | $288.40 | $338.84 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $295.12 Typical High $549.54 | Professional | AS · PA/NP assist | $257.04 | $295.12 | $549.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,819.70 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,819.70 | $1,949.84 | $2,570.40 |
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 $1,819.70 Median $2,511.89 Typical High $5,495.41 | Professional | None | $1,819.70 | $2,511.89 | $5,495.41 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,288.25 Typical High $10,964.78 | Facility | None | $54.95 | $1,288.25 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $13,489.63 | Professional | None | $2,630.27 | $4,677.35 | $13,489.63 |
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 $2,137.96 Median $3,311.31 Typical High $5,754.40 | Professional | None | $2,137.96 | $3,311.31 | $5,754.40 |
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 $1,000.00 Median $1,148.15 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,000.00 | $1,148.15 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $457.09 Typical High $489.78 | Professional | 53 · Discontinued | $398.11 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,737.80 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,479.11 | $1,737.80 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $346.74 Typical High $371.54 | Professional | 55 · Aftercare only | $302.00 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $229.09 Typical High $245.47 | Professional | 56 · Pre-op care only | $199.53 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,621.81 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,621.81 | $1,737.80 |
Where Missouri sits
The same service costs 8.0 times more in Alabama than in Washington. 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
AL $20,353WA $2,540
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.