How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,233Professionalmedian $2,630 · 10th to 90th $1,738 to $5,495
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 $1,737.80 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,737.80 | $2,041.74 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,819.70 | $2,511.89 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,691.53 Median $3,801.89 Typical High $5,248.07 | Professional | 50 · Both sides | $2,691.53 | $3,801.89 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,584.89 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,148.15 | $1,584.89 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $407.38 Typical High $562.34 | Professional | 80 · Assistant surgeon | $288.40 | $407.38 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $354.81 Typical High $489.78 | Professional | AS · PA/NP assist | $251.19 | $354.81 | $489.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,698.24 | $2,290.87 |
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 $1,621.81 Median $2,187.76 Typical High $4,897.79 | Professional | None | $1,621.81 | $2,187.76 | $4,897.79 |
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 $2,398.83 Median $4,466.84 Typical High $12,589.25 | Professional | None | $2,398.83 | $4,466.84 | $12,589.25 |
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 $1,905.46 Median $2,951.21 Typical High $5,128.61 | Professional | None | $1,905.46 | $2,951.21 | $5,128.61 |
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 $870.96 Median $1,023.29 Typical High $1,096.48 | Professional | 52 · Reduced service | $870.96 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $407.38 Typical High $436.52 | Professional | 53 · Discontinued | $354.81 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,513.56 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,318.26 | $1,513.56 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $302.00 Typical High $323.59 | Professional | 55 · Aftercare only | $263.03 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $204.17 Typical High $218.78 | Professional | 56 · Pre-op care only | $173.78 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,412.54 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,412.54 | $1,513.56 |
Where Missouri sits
The same service costs 5.8 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· 18th of 51
$2,630
AK $6,761TX $1,175
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.