How much rates vary
Facilitymedian $2,512 · 10th to 90th $525 to $8,913Professionalmedian $2,089 · 10th to 90th $1,380 to $4,898
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 $1,584.89 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,584.89 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,584.89 | $2,187.76 |
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 $1,412.54 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,412.54 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,258.93 Typical High $1,698.24 | Professional | 62 · Two surgeons | $891.25 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $316.23 Typical High $436.52 | Professional | 80 · Assistant surgeon | $229.09 | $316.23 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $275.42 Typical High $380.19 | Professional | AS · PA/NP assist | $199.53 | $275.42 | $380.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,348.96 | $1,862.09 |
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 $1,258.93 Median $1,698.24 Typical High $3,801.89 | Professional | None | $1,258.93 | $1,698.24 | $3,801.89 |
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 $1,862.09 Median $3,467.37 Typical High $9,332.54 | Professional | None | $1,862.09 | $3,467.37 | $9,332.54 |
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 $1,479.11 Median $2,290.87 Typical High $3,981.07 | Professional | None | $1,479.11 | $2,290.87 | $3,981.07 |
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 $691.83 Median $794.33 Typical High $851.14 | Professional | 52 · Reduced service | $691.83 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $316.23 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,202.26 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,023.29 | $1,202.26 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,122.02 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $954.99 | $1,122.02 | $1,202.26 |
Where Missouri sits
The same service costs 4.9 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· 17th of 51
$2,089
AK $5,248TX $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.