How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,047 to $10,471Professionalmedian $1,413 · 10th to 90th $1,047 to $3,467
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 $1,230.27 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,230.27 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,230.27 | $1,698.24 |
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 $1,071.52 Median $1,288.25 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,288.25 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,905.46 Typical High $3,090.30 | Professional | 50 · Both sides | $1,621.81 | $1,905.46 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $1,318.26 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $204.17 Typical High $331.13 | Professional | 80 · Assistant surgeon | $173.78 | $204.17 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $288.40 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $288.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,445.44 | Professional | None | $954.99 | $1,023.29 | $1,445.44 |
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 $977.24 Median $1,318.26 Typical High $2,951.21 | Professional | None | $977.24 | $1,318.26 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,548.13 Typical High $13,803.84 | Facility | None | $54.95 | $3,548.13 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $7,244.36 | Professional | None | $1,445.44 | $2,754.23 | $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 $1,148.15 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,862.09 | $3,090.30 |
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 $524.81 Median $616.60 Typical High $660.69 | Professional | 52 · Reduced service | $524.81 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $245.47 Typical High $263.03 | Professional | 53 · Discontinued | $208.93 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $912.01 Typical High $977.24 | Professional | 54 · Surgery only | $794.33 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $181.97 Typical High $194.98 | Professional | 55 · Aftercare only | $158.49 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $123.03 Typical High $131.83 | Professional | 56 · Pre-op care only | $104.71 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $851.14 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $741.31 | $851.14 | $912.01 |
Where Missouri sits
The same service costs 5.1 times more in Wisconsin 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· 28th of 51
$1,698
WI $4,677TX $912
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.