How much rates vary
Facilitymedian $1,820 · 10th to 90th $447 to $6,918Professionalmedian $1,230 · 10th to 90th $871 to $2,570
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 $933.25 Median $4,897.79 Typical High $7,762.47 | Facility | None | $933.25 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,288.25 | Professional | None | $812.83 | $933.25 | $1,288.25 |
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 $891.25 Median $1,230.27 Typical High $1,584.89 | Professional | None | $891.25 | $1,230.27 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $776.25 Typical High $1,000.00 | Professional | 62 · Two surgeons | $562.34 | $776.25 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $199.53 Typical High $257.04 | Professional | 80 · Assistant surgeon | $144.54 | $199.53 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $173.78 Typical High $223.87 | Professional | AS · PA/NP assist | $125.89 | $173.78 | $223.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,122.02 | Professional | None | $741.31 | $794.33 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $2,691.53 | Facility | None | $588.84 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $2,290.87 | Professional | None | $741.31 | $1,047.13 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,096.48 Typical High $9,772.37 | Facility | None | $54.95 | $1,096.48 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $7,413.10 | Professional | None | $1,148.15 | $2,290.87 | $7,413.10 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,513.56 Typical High $2,511.89 | Professional | None | $912.01 | $1,513.56 | $2,511.89 |
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 $407.38 Median $467.74 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $660.69 | $707.95 |
Where Missouri sits
The same service costs 4.4 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
$1,259
AK $3,020TX $692
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.