How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $8,710Professionalmedian $3,631 · 10th to 90th $2,692 to $8,318
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 $2,818.38 Median $3,311.31 Typical High $4,265.80 | Professional | None | $2,818.38 | $3,311.31 | $4,265.80 |
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 $2,754.23 Median $3,630.78 Typical High $5,495.41 | Professional | None | $2,754.23 | $3,630.78 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $2,290.87 Typical High $3,467.37 | Professional | 62 · Two surgeons | $1,737.80 | $2,290.87 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $588.84 Typical High $891.25 | Professional | 80 · Assistant surgeon | $436.52 | $588.84 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $512.86 Typical High $776.25 | Professional | AS · PA/NP assist | $389.05 | $512.86 | $776.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,630.27 Median $2,818.38 Typical High $3,715.35 | Professional | None | $2,630.27 | $2,818.38 | $3,715.35 |
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 $2,570.40 Median $3,467.37 Typical High $7,943.28 | Professional | None | $2,570.40 | $3,467.37 | $7,943.28 |
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 $3,548.13 Median $7,244.36 Typical High $20,892.96 | Professional | None | $3,548.13 | $7,244.36 | $20,892.96 |
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 $2,884.03 Median $4,786.30 Typical High $8,317.64 | Professional | None | $2,884.03 | $4,786.30 | $8,317.64 |
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 $1,412.54 Median $1,659.59 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,412.54 | $1,659.59 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $660.69 Typical High $707.95 | Professional | 53 · Discontinued | $575.44 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,454.71 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,137.96 | $2,454.71 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $489.78 Typical High $524.81 | Professional | 55 · Aftercare only | $426.58 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $331.13 Typical High $354.81 | Professional | 56 · Pre-op care only | $281.84 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,290.87 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,290.87 | $2,454.71 |
Where Missouri sits
The same service costs 6.9 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 $22,987WA $3,314
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.