How much rates vary
Facilitymedian $2,692 · 10th to 90th $501 to $7,943Professionalmedian $4,074 · 10th to 90th $3,090 to $9,333
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 $2,511.89 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,511.89 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $4,168.69 | Professional | None | $3,311.31 | $3,890.45 | $4,168.69 |
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 $3,090.30 Median $3,548.13 Typical High $6,606.93 | Professional | None | $3,090.30 | $3,548.13 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $575.44 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $489.78 | $575.44 | $1,047.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $426.58 Median $501.19 Typical High $912.01 | Professional | AS · PA/NP assist | $426.58 | $501.19 | $912.01 |
BCBS Kansas City Setting Professional Modifier None Typical Low $3,019.95 Median $3,235.94 Typical High $4,365.16 | Professional | None | $3,019.95 | $3,235.94 | $4,365.16 |
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 $3,019.95 Median $4,265.80 Typical High $9,332.54 | Professional | None | $3,019.95 | $4,265.80 | $9,332.54 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $10,964.78 | Facility | None | $54.95 | $1,348.96 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $4,365.16 Median $7,762.47 Typical High $22,908.68 | Professional | None | $4,365.16 | $7,762.47 | $22,908.68 |
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 $3,630.78 Median $5,623.41 Typical High $9,772.37 | Professional | None | $3,630.78 | $5,623.41 | $9,772.37 |
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 $1,659.59 Median $1,949.84 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,659.59 | $1,949.84 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $776.25 Typical High $831.76 | Professional | 53 · Discontinued | $660.69 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,884.03 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,511.89 | $2,884.03 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $575.44 Typical High $616.60 | Professional | 55 · Aftercare only | $501.19 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $389.05 Typical High $416.87 | Professional | 56 · Pre-op care only | $331.13 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,691.53 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,691.53 | $2,884.03 |
Where Missouri sits
The same service costs 7.1 times more in Alaska than in Arkansas. 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· 32nd of 51
$3,802
AK $12,882AR $1,820
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.