How much rates vary
Facilitymedian $2,630 · 10th to 90th $525 to $8,710Professionalmedian $3,631 · 10th to 90th $2,399 to $7,413
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 $2,951.21 Typical High $3,801.89 | Professional | None | $2,511.89 | $2,951.21 | $3,801.89 |
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 $2,290.87 Median $3,235.94 Typical High $4,897.79 | Professional | None | $2,290.87 | $3,235.94 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $2,041.74 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,445.44 | $2,041.74 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $524.81 Typical High $794.33 | Professional | 80 · Assistant surgeon | $371.54 | $524.81 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $457.09 Typical High $691.83 | Professional | AS · PA/NP assist | $323.59 | $457.09 | $691.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,344.23 Median $2,511.89 Typical High $3,311.31 | Professional | None | $2,344.23 | $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 $2,754.23 Typical High $7,079.46 | Professional | None | $2,290.87 | $2,754.23 | $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 $2,818.38 Median $6,456.54 Typical High $22,908.68 | Professional | None | $2,818.38 | $6,456.54 | $22,908.68 |
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 $7,413.10 | Professional | None | $2,570.40 | $4,265.80 | $7,413.10 |
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 $1,479.11 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,258.93 | $1,479.11 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $588.84 Typical High $630.96 | Professional | 53 · Discontinued | $512.86 | $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 $295.12 Typical High $316.23 | Professional | 56 · Pre-op care only | $251.19 | $295.12 | $316.23 |
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 6.3 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· 21st of 51
$3,236
AK $9,772TX $1,549
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.