How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,233Professionalmedian $2,188 · 10th to 90th $1,660 to $5,012
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 $1,778.28 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,778.28 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,659.59 | $1,949.84 | $2,570.40 |
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 $1,698.24 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,698.24 | $2,041.74 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $3,090.30 Typical High $5,011.87 | Professional | 50 · Both sides | $2,570.40 | $3,090.30 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,288.25 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,071.52 | $1,288.25 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $323.59 Typical High $524.81 | Professional | 80 · Assistant surgeon | $275.42 | $323.59 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $288.40 Typical High $467.74 | Professional | AS · PA/NP assist | $239.88 | $288.40 | $467.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,621.81 | $2,187.76 |
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 $1,548.82 Median $2,041.74 Typical High $4,677.35 | Professional | None | $1,548.82 | $2,041.74 | $4,677.35 |
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 $2,238.72 Median $4,265.80 Typical High $11,481.54 | Professional | None | $2,238.72 | $4,265.80 | $11,481.54 |
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 $1,819.70 Median $2,818.38 Typical High $4,897.79 | Professional | None | $1,819.70 | $2,818.38 | $4,897.79 |
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 $831.76 Median $977.24 Typical High $1,047.13 | Professional | 52 · Reduced service | $831.76 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $389.05 Typical High $416.87 | Professional | 53 · Discontinued | $338.84 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,445.44 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,258.93 | $1,445.44 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $288.40 Typical High $316.23 | Professional | 55 · Aftercare only | $251.19 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $194.98 Typical High $208.93 | Professional | 56 · Pre-op care only | $165.96 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,348.96 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,348.96 | $1,479.11 |
Where Missouri sits
The same service costs 8.2 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 $19,170WA $2,342
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.