How much rates vary
Facilitymedian $2,570 · 10th to 90th $525 to $8,511Professionalmedian $2,754 · 10th to 90th $1,820 to $5,754
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 $1,819.70 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,819.70 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,819.70 | $2,089.30 | $2,884.03 |
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 $1,862.09 Median $2,754.23 Typical High $3,630.78 | Professional | None | $1,862.09 | $2,754.23 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,698.24 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,174.90 | $1,698.24 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $436.52 Typical High $575.44 | Professional | 80 · Assistant surgeon | $302.00 | $436.52 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $380.19 Typical High $501.19 | Professional | AS · PA/NP assist | $263.03 | $380.19 | $501.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,659.59 | $1,778.28 | $2,398.83 |
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 $4,570.88 Typical High $18,620.87 | Professional | None | $2,454.71 | $4,570.88 | $18,620.87 |
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 $3,019.95 Typical High $5,248.07 | Professional | None | $1,995.26 | $3,019.95 | $5,248.07 |
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 $1,047.13 Typical High $1,122.02 | Professional | 52 · Reduced service | $912.01 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $416.87 Typical High $446.68 | Professional | 53 · Discontinued | $363.08 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,584.89 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,348.96 | $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 $181.97 Median $208.93 Typical High $223.87 | Professional | 56 · Pre-op care only | $181.97 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,479.11 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,479.11 | $1,584.89 |
Where Missouri sits
The same service costs 5.5 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· 16th of 51
$2,754
AK $6,918TX $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.