How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $8,710Professionalmedian $3,631 · 10th to 90th $2,344 to $9,772
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 $2,398.83 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,398.83 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,754.23 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,754.23 | $2,951.21 |
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 $2,511.89 Median $3,467.37 Typical High $4,897.79 | Professional | None | $2,511.89 | $3,467.37 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $549.54 Typical High $794.33 | Professional | 80 · Assistant surgeon | $398.11 | $549.54 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $489.78 Typical High $691.83 | Professional | AS · PA/NP assist | $346.74 | $489.78 | $691.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $3,090.30 | Professional | None | $2,187.76 | $2,344.23 | $3,090.30 |
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 $2,187.76 Median $2,951.21 Typical High $6,606.93 | Professional | None | $2,187.76 | $2,951.21 | $6,606.93 |
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 $3,090.30 Median $6,025.60 Typical High $30,902.95 | Professional | None | $3,090.30 | $6,025.60 | $30,902.95 |
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 $2,570.40 Median $3,981.07 Typical High $6,918.31 | Professional | None | $2,570.40 | $3,981.07 | $6,918.31 |
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 $1,202.26 Median $1,380.38 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,202.26 | $1,380.38 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $549.54 Typical High $588.84 | Professional | 53 · Discontinued | $478.63 | $549.54 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,089.30 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,778.28 | $2,089.30 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $416.87 Typical High $446.68 | Professional | 55 · Aftercare only | $354.81 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $275.42 Typical High $295.12 | Professional | 56 · Pre-op care only | $239.88 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,949.84 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,949.84 | $2,089.30 |
Where Missouri sits
The same service costs 6.9 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· 15th of 51
$3,388
AK $9,120TX $1,318
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.