How much rates vary
Facilitymedian $2,512 · 10th to 90th $525 to $8,913Professionalmedian $1,950 · 10th to 90th $1,259 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 $1,513.56 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,513.56 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,513.56 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,762.47 | Facility | None | $1,479.11 | $3,467.37 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,348.96 | $1,862.09 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,754.23 Typical High $3,890.45 | Professional | 50 · Both sides | $2,041.74 | $2,754.23 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,174.90 Typical High $1,621.81 | Professional | 62 · Two surgeons | $851.14 | $1,174.90 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $295.12 Typical High $407.38 | Professional | 80 · Assistant surgeon | $213.80 | $295.12 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $257.04 Typical High $363.08 | Professional | AS · PA/NP assist | $190.55 | $257.04 | $363.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,202.26 | $1,584.89 |
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 $1,202.26 Median $1,584.89 Typical High $3,388.44 | Professional | None | $1,202.26 | $1,584.89 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,318.26 Typical High $11,220.18 | Facility | None | $54.95 | $1,318.26 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,737.80 Median $3,311.31 Typical High $8,912.51 | Professional | None | $1,737.80 | $3,311.31 | $8,912.51 |
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 $1,412.54 Median $2,187.76 Typical High $3,801.89 | Professional | None | $1,412.54 | $2,187.76 | $3,801.89 |
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 $660.69 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $194.98 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $1,071.52 | $1,071.52 |
Where Missouri sits
The same service costs 6.4 times more in Alaska than in Maryland. 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
AK $12,091MD $1,881
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.