How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $8,710Professionalmedian $3,467 · 10th to 90th $2,399 to $7,244
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 $2,511.89 Median $2,884.03 Typical High $4,073.80 | Professional | None | $2,511.89 | $2,884.03 | $4,073.80 |
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 $2,454.71 Median $3,388.44 Typical High $4,897.79 | Professional | None | $2,454.71 | $3,388.44 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,089.30 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,548.82 | $2,089.30 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $537.03 Typical High $794.33 | Professional | 80 · Assistant surgeon | $389.05 | $537.03 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $467.74 Typical High $691.83 | Professional | AS · PA/NP assist | $346.74 | $467.74 | $691.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $3,311.31 | Professional | None | $2,290.87 | $2,511.89 | $3,311.31 |
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 $2,290.87 Median $3,090.30 Typical High $7,079.46 | Professional | None | $2,290.87 | $3,090.30 | $7,079.46 |
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 $3,162.28 Median $6,456.54 Typical High $19,952.62 | Professional | None | $3,162.28 | $6,456.54 | $19,952.62 |
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 $2,570.40 Median $4,265.80 Typical High $7,244.36 | Professional | None | $2,570.40 | $4,265.80 | $7,244.36 |
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 $1,258.93 Median $1,445.44 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,258.93 | $1,445.44 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $588.84 Typical High $630.96 | Professional | 53 · Discontinued | $501.19 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,187.76 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,905.46 | $2,187.76 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $436.52 Typical High $467.74 | Professional | 55 · Aftercare only | $380.19 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $288.40 Typical High $309.03 | Professional | 56 · Pre-op care only | $251.19 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,041.74 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,041.74 | $2,187.76 |
Where Missouri sits
The same service costs 7.1 times more in Alaska 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
AK $21,795WA $3,065
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.