How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,233Professionalmedian $1,950 · 10th to 90th $1,413 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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,479.11 | $1,698.24 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,445.44 | $1,659.59 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,454.71 Typical High $4,365.16 | Professional | 50 · Both sides | $2,137.96 | $2,454.71 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,047.13 Typical High $1,819.70 | Professional | 62 · Two surgeons | $912.01 | $1,047.13 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $263.03 Typical High $467.74 | Professional | 80 · Assistant surgeon | $229.09 | $263.03 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $229.09 Typical High $407.38 | Professional | AS · PA/NP assist | $199.53 | $229.09 | $407.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,445.44 | $1,905.46 |
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 $1,348.96 Median $1,862.09 Typical High $4,168.69 | Professional | None | $1,348.96 | $1,862.09 | $4,168.69 |
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 $1,995.26 Median $3,715.35 Typical High $10,000.00 | Professional | None | $1,995.26 | $3,715.35 | $10,000.00 |
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 $1,621.81 Median $2,511.89 Typical High $4,265.80 | Professional | None | $1,621.81 | $2,511.89 | $4,265.80 |
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 $741.31 Median $851.14 Typical High $912.01 | Professional | 52 · Reduced service | $741.31 | $851.14 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $346.74 Typical High $371.54 | Professional | 53 · Discontinued | $295.12 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,288.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,122.02 | $1,288.25 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $257.04 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $169.82 Typical High $181.97 | Professional | 56 · Pre-op care only | $147.91 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,202.26 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,202.26 | $1,288.25 |
Where Missouri sits
The same service costs 5.2 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· 23rd of 51
$2,089
AK $5,623TX $1,072
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.