How much rates vary
Facilitymedian $2,630 · 10th to 90th $525 to $8,511Professionalmedian $3,090 · 10th to 90th $2,042 to $8,128
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 $2,041.74 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,041.74 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $2,511.89 | Professional | None | $2,041.74 | $2,344.23 | $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 $2,089.30 Median $3,019.95 Typical High $4,168.69 | Professional | None | $2,089.30 | $3,019.95 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,905.46 Typical High $2,630.27 | Professional | 62 · Two surgeons | $1,318.26 | $1,905.46 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $489.78 Typical High $660.69 | Professional | 80 · Assistant surgeon | $338.84 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $426.58 Typical High $575.44 | Professional | AS · PA/NP assist | $295.12 | $426.58 | $575.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,862.09 | $1,995.26 | $2,691.53 |
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 $1,862.09 Median $2,511.89 Typical High $5,623.41 | Professional | None | $1,862.09 | $2,511.89 | $5,623.41 |
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 $2,691.53 Median $5,128.61 Typical High $24,547.09 | Professional | None | $2,691.53 | $5,128.61 | $24,547.09 |
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 $2,187.76 Median $3,388.44 Typical High $5,888.44 | Professional | None | $2,187.76 | $3,388.44 | $5,888.44 |
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 $1,000.00 Median $1,174.90 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,000.00 | $1,174.90 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $467.74 Typical High $501.19 | Professional | 53 · Discontinued | $407.38 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,737.80 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,513.56 | $1,737.80 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $346.74 Typical High $371.54 | Professional | 55 · Aftercare only | $302.00 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $234.42 Typical High $251.19 | Professional | 56 · Pre-op care only | $204.17 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,621.81 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,621.81 | $1,737.80 |
Where Missouri sits
The same service costs 6.2 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
$3,020
AK $7,762TX $1,259
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.