How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $9,550Professionalmedian $813 · 10th to 90th $407 to $2,455
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 $2,398.83 Median $5,370.32 Typical High $8,317.64 | Facility | None | $2,398.83 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $4,570.88 | Professional | None | $407.38 | $467.74 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $3,981.07 Typical High $10,471.29 | Facility | None | $1,513.56 | $3,981.07 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $794.33 Typical High $1,071.52 | Professional | None | $436.52 | $794.33 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $1,202.26 Typical High $1,621.81 | Professional | 50 · Both sides | $660.69 | $1,202.26 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $501.19 Typical High $676.08 | Professional | 62 · Two surgeons | $275.42 | $501.19 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $128.82 Typical High $173.78 | Professional | 80 · Assistant surgeon | $69.18 | $128.82 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $112.20 Typical High $151.36 | Professional | AS · PA/NP assist | $61.66 | $112.20 | $151.36 |
BCBS Kansas City Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $588.84 | Professional | None | $363.08 | $398.11 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $2,691.53 | Facility | None | $588.84 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $1,288.25 | Professional | None | $371.54 | $549.54 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,122.02 Typical High $6,918.31 | Facility | None | $54.95 | $1,122.02 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,096.48 Typical High $3,981.07 | Professional | None | $616.60 | $1,096.48 | $3,981.07 |
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 $436.52 Median $870.96 Typical High $1,174.90 | Professional | None | $436.52 | $870.96 | $1,174.90 |
5 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 $204.17 Median $234.42 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $93.33 Typical High $100.00 | Professional | 53 · Discontinued | $81.28 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $302.00 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $70.79 Typical High $75.86 | Professional | 55 · Aftercare only | $60.26 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $40.74 | $46.77 | $50.12 |
Where Missouri sits
The same service costs 3.7 times more in Wisconsin than in New York. 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· 7th of 51
$955
WI $1,622NY $437
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.