How much rates vary
Facilitymedian $2,570 · 10th to 90th $525 to $8,511Professionalmedian $3,236 · 10th to 90th $2,089 to $8,710
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 $2,137.96 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,137.96 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $2,630.27 | Professional | None | $2,137.96 | $2,454.71 | $2,630.27 |
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 $2,187.76 Median $3,090.30 Typical High $4,168.69 | Professional | None | $2,187.76 | $3,090.30 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $489.78 Typical High $660.69 | Professional | 80 · Assistant surgeon | $346.74 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $426.58 Typical High $588.84 | Professional | AS · PA/NP assist | $302.00 | $426.58 | $588.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,949.84 | $2,089.30 | $2,818.38 |
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 $1,949.84 Median $2,511.89 Typical High $5,888.44 | Professional | None | $1,949.84 | $2,511.89 | $5,888.44 |
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 $2,630.27 Median $5,370.32 Typical High $22,387.21 | Professional | None | $2,630.27 | $5,370.32 | $22,387.21 |
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 $2,137.96 Median $3,548.13 Typical High $6,165.95 | Professional | None | $2,137.96 | $3,548.13 | $6,165.95 |
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 $1,071.52 Median $1,230.27 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,071.52 | $1,230.27 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $489.78 Typical High $524.81 | Professional | 53 · Discontinued | $426.58 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,862.09 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,584.89 | $1,862.09 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $371.54 Typical High $398.11 | Professional | 55 · Aftercare only | $316.23 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $245.47 Typical High $263.03 | Professional | 56 · Pre-op care only | $213.80 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,737.80 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,737.80 | $1,819.70 |
Where Missouri sits
The same service costs 5.2 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· 17th of 51
$3,020
AK $8,128TX $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.