How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $8,913Professionalmedian $4,467 · 10th to 90th $3,311 to $9,550
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 $4,897.79 Typical High $7,762.47 | Facility | None | $2,511.89 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $4,570.88 | Professional | None | $3,311.31 | $3,890.45 | $4,570.88 |
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 $3,467.37 Median $4,466.84 Typical High $6,025.60 | Professional | None | $3,467.37 | $4,466.84 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,187.76 Median $2,818.38 Typical High $3,801.89 | Professional | 62 · Two surgeons | $2,187.76 | $2,818.38 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $562.34 Median $707.95 Typical High $977.24 | Professional | 80 · Assistant surgeon | $562.34 | $707.95 | $977.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $489.78 Median $630.96 Typical High $831.76 | Professional | AS · PA/NP assist | $489.78 | $630.96 | $831.76 |
BCBS Kansas City Setting Professional Modifier None Typical Low $3,090.30 Median $3,311.31 Typical High $4,466.84 | Professional | None | $3,090.30 | $3,311.31 | $4,466.84 |
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 $3,019.95 Median $3,981.07 Typical High $9,332.54 | Professional | None | $3,019.95 | $3,981.07 | $9,332.54 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,481.54 | Facility | None | $54.95 | $1,380.38 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $4,265.80 Median $8,511.38 Typical High $26,915.35 | Professional | None | $4,265.80 | $8,511.38 | $26,915.35 |
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 $3,630.78 Median $5,623.41 Typical High $9,549.93 | Professional | None | $3,630.78 | $5,623.41 | $9,549.93 |
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 $1,659.59 Median $1,905.46 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,659.59 | $1,905.46 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $776.25 Typical High $812.83 | Professional | 53 · Discontinued | $660.69 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,884.03 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,511.89 | $2,884.03 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $575.44 Typical High $616.60 | Professional | 55 · Aftercare only | $501.19 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $389.05 Typical High $407.38 | Professional | 56 · Pre-op care only | $331.13 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,691.53 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,691.53 | $2,884.03 |
Where Missouri sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 25th of 51
$4,266
AK $12,589AR $1,995
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.