How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,233Professionalmedian $2,630 · 10th to 90th $1,738 to $6,310
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 $2,187.76 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,187.76 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $2,691.53 | Professional | None | $2,187.76 | $2,511.89 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $3,890.45 Typical High $10,471.29 | Facility | None | $1,513.56 | $3,890.45 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $3,801.89 | Professional | None | $1,737.80 | $2,290.87 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $3,388.44 Typical High $5,754.40 | Professional | 50 · Both sides | $2,570.40 | $3,388.44 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,412.54 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,096.48 | $1,412.54 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $363.08 Typical High $602.56 | Professional | 80 · Assistant surgeon | $275.42 | $363.08 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $316.23 Typical High $537.03 | Professional | AS · PA/NP assist | $239.88 | $316.23 | $537.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,949.84 | $2,089.30 | $2,818.38 |
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 $1,995.26 Median $2,570.40 Typical High $6,025.60 | Professional | None | $1,995.26 | $2,570.40 | $6,025.60 |
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 $2,691.53 Median $5,495.41 Typical High $15,135.61 | Professional | None | $2,691.53 | $5,495.41 | $15,135.61 |
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 $2,187.76 Median $3,548.13 Typical High $6,309.57 | Professional | None | $2,187.76 | $3,548.13 | $6,309.57 |
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 $1,096.48 Median $1,258.93 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,096.48 | $1,258.93 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $501.19 Typical High $537.03 | Professional | 53 · Discontinued | $436.52 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,905.46 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,621.81 | $1,905.46 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $380.19 Typical High $398.11 | Professional | 55 · Aftercare only | $323.59 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $251.19 Typical High $269.15 | Professional | 56 · Pre-op care only | $218.78 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,778.28 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,778.28 | $1,862.09 |
Where Missouri sits
The same service costs 7.2 times more in Alabama than in Washington. 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
AL $19,737WA $2,745
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.