How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,175 to $12,303Professionalmedian $1,072 · 10th to 90th $692 to $2,884
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 $1,698.24 Median $5,754.40 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,754.40 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $2,041.74 | Professional | None | $691.83 | $794.33 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $812.83 | Professional | None | $691.83 | $691.83 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,762.47 | Facility | None | $1,318.26 | $3,467.37 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,380.38 | Professional | None | $724.44 | $1,071.52 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $676.08 Typical High $870.96 | Professional | 62 · Two surgeons | $446.68 | $676.08 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $169.82 Typical High $223.87 | Professional | 80 · Assistant surgeon | $114.82 | $169.82 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $147.91 Typical High $194.98 | Professional | AS · PA/NP assist | $100.00 | $147.91 | $194.98 |
BCBS Kansas City Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $891.25 | Professional | None | $616.60 | $660.69 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,981.07 Typical High $5,754.40 | Facility | None | $758.58 | $3,981.07 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,479.11 | Professional | None | $630.96 | $851.14 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $5,011.87 Typical High $26,302.68 | Facility | None | $954.99 | $5,011.87 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,737.80 Typical High $5,888.44 | Professional | None | $912.01 | $1,737.80 | $5,888.44 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,677.35 Typical High $11,748.98 | Facility | None | $977.24 | $4,677.35 | $11,748.98 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $1,995.26 | Professional | None | $741.31 | $1,148.15 | $1,995.26 |
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 $346.74 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $346.74 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $158.49 Typical High $169.82 | Professional | 53 · Discontinued | $138.04 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $562.34 | $602.56 |
Where Missouri sits
The same service costs 5.3 times more in Wisconsin than in Montana. 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
WI $10,556MT $2,002
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.