How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,047 to $10,471Professionalmedian $1,349 · 10th to 90th $1,023 to $3,548
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 $1,174.90 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,174.90 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,174.90 | $1,621.81 |
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 $1,047.13 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,318.26 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,995.26 Typical High $3,019.95 | Professional | 50 · Both sides | $1,584.89 | $1,995.26 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $831.76 Typical High $1,258.93 | Professional | 62 · Two surgeons | $660.69 | $831.76 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $213.80 Typical High $323.59 | Professional | 80 · Assistant surgeon | $169.82 | $213.80 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $186.21 Typical High $281.84 | Professional | AS · PA/NP assist | $147.91 | $186.21 | $281.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,318.26 | Professional | None | $933.25 | $1,000.00 | $1,318.26 |
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 $933.25 Median $1,258.93 Typical High $2,884.03 | Professional | None | $933.25 | $1,258.93 | $2,884.03 |
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 $1,380.38 Median $2,570.40 Typical High $6,918.31 | Professional | None | $1,380.38 | $2,570.40 | $6,918.31 |
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 $1,122.02 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,122.02 | $1,737.80 | $2,951.21 |
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 $512.86 Median $588.84 Typical High $630.96 | Professional | 52 · Reduced service | $512.86 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $234.42 Typical High $251.19 | Professional | 53 · Discontinued | $204.17 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $891.25 Typical High $954.99 | Professional | 54 · Surgery only | $758.58 | $891.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $177.83 Typical High $190.55 | Professional | 55 · Aftercare only | $154.88 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $117.49 Typical High $125.89 | Professional | 56 · Pre-op care only | $102.33 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $831.76 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $707.95 | $831.76 | $891.25 |
Where Missouri sits
The same service costs 5.0 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· 25th of 51
$1,622
WI $4,365TX $871
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.