How much rates vary
Facilitymedian $2,512 · 10th to 90th $525 to $8,913Professionalmedian $1,820 · 10th to 90th $1,202 to $4,898
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 $1,380.38 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,380.38 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,380.38 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,762.47 | Facility | None | $1,479.11 | $3,467.37 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,737.80 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,096.48 Typical High $1,584.89 | Professional | 62 · Two surgeons | $776.25 | $1,096.48 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $275.42 Typical High $398.11 | Professional | 80 · Assistant surgeon | $199.53 | $275.42 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $239.88 Typical High $346.74 | Professional | AS · PA/NP assist | $173.78 | $239.88 | $346.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,174.90 | $1,584.89 |
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 $1,096.48 Median $1,513.56 Typical High $3,311.31 | Professional | None | $1,096.48 | $1,513.56 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,318.26 Typical High $11,220.18 | Facility | None | $54.95 | $1,318.26 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $3,019.95 Typical High $12,022.64 | Professional | None | $1,584.89 | $3,019.95 | $12,022.64 |
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 $1,288.25 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,288.25 | $1,995.26 | $3,467.37 |
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 $602.56 Median $691.83 Typical High $741.31 | Professional | 52 · Reduced service | $602.56 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $275.42 Typical High $295.12 | Professional | 53 · Discontinued | $239.88 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,047.13 Typical High $1,096.48 | Professional | 54 · Surgery only | $891.25 | $1,047.13 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $208.93 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $138.04 Typical High $147.91 | Professional | 56 · Pre-op care only | $120.23 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $977.24 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $977.24 | $1,023.29 |
Where Missouri sits
The same service costs 5.6 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· 13th of 51
$1,950
AK $4,571TX $813
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.