How much rates vary
Facilitymedian $2,570 · 10th to 90th $525 to $8,511Professionalmedian $2,818 · 10th to 90th $1,862 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 $1,862.09 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,862.09 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,862.09 | $2,137.96 | $2,511.89 |
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 $1,905.46 Median $2,754.23 Typical High $3,981.07 | Professional | None | $1,905.46 | $2,754.23 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,737.80 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,202.26 | $1,737.80 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $446.68 Typical High $630.96 | Professional | 80 · Assistant surgeon | $302.00 | $446.68 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $389.05 Typical High $549.54 | Professional | AS · PA/NP assist | $269.15 | $389.05 | $549.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,698.24 | $1,819.70 | $2,454.71 |
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 $1,659.59 Median $2,238.72 Typical High $5,128.61 | Professional | None | $1,659.59 | $2,238.72 | $5,128.61 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,220.18 | Facility | None | $54.95 | $1,380.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $2,454.71 Median $4,677.35 Typical High $23,442.29 | Professional | None | $2,454.71 | $4,677.35 | $23,442.29 |
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 $1,995.26 Median $3,090.30 Typical High $5,370.32 | Professional | None | $1,995.26 | $3,090.30 | $5,370.32 |
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 $912.01 Median $1,071.52 Typical High $1,148.15 | Professional | 52 · Reduced service | $912.01 | $1,071.52 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $426.58 Typical High $457.09 | Professional | 53 · Discontinued | $371.54 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,584.89 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,380.38 | $1,584.89 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $316.23 Typical High $338.84 | Professional | 55 · Aftercare only | $275.42 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $213.80 Typical High $229.09 | Professional | 56 · Pre-op care only | $186.21 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,479.11 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,479.11 | $1,584.89 |
Where Missouri sits
The same service costs 5.9 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· 15th of 51
$2,754
AK $7,079TX $1,202
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.