How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,000 to $7,413Professionalmedian $1,318 · 10th to 90th $1,000 to $3,162
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 $1,148.15 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,148.15 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,148.15 | $1,584.89 |
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 $1,023.29 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,318.26 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $831.76 Typical High $1,258.93 | Professional | 62 · Two surgeons | $645.65 | $831.76 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $316.23 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $186.21 Typical High $275.42 | Professional | AS · PA/NP assist | $144.54 | $186.21 | $275.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,288.25 | Professional | None | $891.25 | $977.24 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,089.30 Typical High $2,691.53 | Facility | None | $707.95 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $2,754.23 | Professional | None | $912.01 | $1,230.27 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,290.87 Typical High $7,943.28 | Facility | None | $54.95 | $2,290.87 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,630.27 Typical High $7,413.10 | Professional | None | $1,348.96 | $2,630.27 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,071.52 | $1,737.80 | $2,884.03 |
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 $501.19 Median $575.44 Typical High $616.60 | Professional | 52 · Reduced service | $501.19 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $229.09 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $114.82 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $812.83 | $870.96 |
Where Missouri sits
The same service costs 4.6 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· 29th of 51
$1,549
WI $3,981TX $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.