How much rates vary
Facilitymedian $3,631 · 10th to 90th $912 to $10,471Professionalmedian $933 · 10th to 90th $617 to $2,512
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 $724.44 Median $4,897.79 Typical High $7,762.47 | Facility | None | $724.44 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,548.82 | Professional | None | $616.60 | $724.44 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,762.47 | Facility | None | $1,318.26 | $3,467.37 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,230.27 | Professional | None | $645.65 | $870.96 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,318.26 Typical High $1,819.70 | Professional | 50 · Both sides | $977.24 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $549.54 Typical High $776.25 | Professional | 62 · Two surgeons | $407.38 | $549.54 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $141.25 Typical High $194.98 | Professional | 80 · Assistant surgeon | $102.33 | $141.25 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $123.03 Typical High $169.82 | Professional | AS · PA/NP assist | $91.20 | $123.03 | $169.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $794.33 | Professional | None | $562.34 | $602.56 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,162.28 Typical High $4,570.88 | Facility | None | $707.95 | $3,162.28 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,698.24 | Professional | None | $562.34 | $758.58 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,467.37 Typical High $13,803.84 | Facility | None | $54.95 | $3,467.37 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $1,584.89 Typical High $7,244.36 | Professional | None | $831.76 | $1,584.89 | $7,244.36 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,778.28 | Professional | None | $676.08 | $1,047.13 | $1,778.28 |
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 $309.03 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $123.03 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $501.19 | $537.03 |
Where Missouri sits
The same service costs 5.6 times more in Wisconsin than in Montana. 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.
Physician feeFacility fee
WI $10,313MT $1,845
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.