How much rates vary
Facilitymedian $2,512 · 10th to 90th $525 to $8,913Professionalmedian $1,950 · 10th to 90th $1,288 to $4,677
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 $1,479.11 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,479.11 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,479.11 | $2,041.74 |
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 $1,318.26 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,862.09 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,174.90 Typical High $1,698.24 | Professional | 62 · Two surgeons | $831.76 | $1,174.90 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $295.12 Typical High $426.58 | Professional | 80 · Assistant surgeon | $213.80 | $295.12 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $263.03 Typical High $380.19 | Professional | AS · PA/NP assist | $186.21 | $263.03 | $380.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,288.25 | $1,737.80 |
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 $1,174.90 Median $1,584.89 Typical High $3,630.78 | Professional | None | $1,174.90 | $1,584.89 | $3,630.78 |
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 $1,698.24 Median $3,235.94 Typical High $13,489.63 | Professional | None | $1,698.24 | $3,235.94 | $13,489.63 |
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 $1,380.38 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,380.38 | $2,137.96 | $3,715.35 |
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 $645.65 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $295.12 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $147.91 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $1,047.13 | $1,122.02 |
Where Missouri sits
The same service costs 5.4 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
$2,042
AK $5,012TX $933
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.