How much rates vary
Facilitymedian $2,570 · 10th to 90th $525 to $8,511Professionalmedian $2,884 · 10th to 90th $1,905 to $6,918
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 $1,905.46 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,905.46 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,905.46 | $2,187.76 | $3,019.95 |
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 $1,949.84 Median $2,884.03 Typical High $3,801.89 | Professional | None | $1,949.84 | $2,884.03 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,778.28 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,230.27 | $1,778.28 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $457.09 Typical High $602.56 | Professional | 80 · Assistant surgeon | $316.23 | $457.09 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $398.11 Typical High $524.81 | Professional | AS · PA/NP assist | $275.42 | $398.11 | $524.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,778.28 | $1,905.46 | $2,570.40 |
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 $1,737.80 Median $2,344.23 Typical High $5,370.32 | Professional | None | $1,737.80 | $2,344.23 | $5,370.32 |
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 $2,511.89 Median $4,897.79 Typical High $19,498.45 | Professional | None | $2,511.89 | $4,897.79 | $19,498.45 |
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 $2,089.30 Median $3,162.28 Typical High $5,495.41 | Professional | None | $2,089.30 | $3,162.28 | $5,495.41 |
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 $954.99 Median $1,096.48 Typical High $1,174.90 | Professional | 52 · Reduced service | $954.99 | $1,096.48 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $446.68 Typical High $478.63 | Professional | 53 · Discontinued | $380.19 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,659.59 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,445.44 | $1,659.59 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $331.13 Typical High $354.81 | Professional | 55 · Aftercare only | $288.40 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $218.78 Typical High $234.42 | Professional | 56 · Pre-op care only | $190.55 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,548.82 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,548.82 | $1,659.59 |
Where Missouri sits
The same service costs 7.9 times more in Alabama 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
AL $20,238WA $2,549
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.