How much rates vary
Facilitymedian $2,512 · 10th to 90th $525 to $8,710Professionalmedian $2,042 · 10th to 90th $1,349 to $5,129
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 $1,548.82 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,548.82 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,548.82 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,905.46 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $309.03 Typical High $457.09 | Professional | 80 · Assistant surgeon | $223.87 | $309.03 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $269.15 Typical High $398.11 | Professional | AS · PA/NP assist | $194.98 | $269.15 | $398.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,348.96 | $1,819.70 |
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 $1,230.27 Median $1,659.59 Typical High $3,801.89 | Professional | None | $1,230.27 | $1,659.59 | $3,801.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $11,220.18 | Facility | None | $54.95 | $1,348.96 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,737.80 Median $3,388.44 Typical High $12,882.50 | Professional | None | $1,737.80 | $3,388.44 | $12,882.50 |
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 $1,412.54 Median $2,238.72 Typical High $3,890.45 | Professional | None | $1,412.54 | $2,238.72 | $3,890.45 |
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 $676.08 Median $776.25 Typical High $831.76 | Professional | 52 · Reduced service | $676.08 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $309.03 Typical High $331.13 | Professional | 53 · Discontinued | $269.15 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,174.90 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,000.00 | $1,174.90 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $234.42 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $154.88 Typical High $165.96 | Professional | 56 · Pre-op care only | $134.90 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,096.48 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $933.25 | $1,096.48 | $1,174.90 |
Where Missouri sits
The same service costs 4.9 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· 16th of 51
$2,089
AK $5,248TX $1,072
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.