How much rates vary
Facilitymedian $1,995 · 10th to 90th $447 to $6,607Professionalmedian $692 · 10th to 90th $490 to $1,660
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 $630.96 Median $4,897.79 Typical High $7,762.47 | Facility | None | $630.96 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $870.96 | Professional | None | $537.03 | $630.96 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $478.63 Median $676.08 Typical High $1,047.13 | Professional | None | $478.63 | $676.08 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $426.58 Typical High $660.69 | Professional | 62 · Two surgeons | $302.00 | $426.58 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $107.15 Typical High $165.96 | Professional | 80 · Assistant surgeon | $77.62 | $107.15 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $93.33 Typical High $144.54 | Professional | AS · PA/NP assist | $67.61 | $93.33 | $144.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $676.08 | Professional | None | $467.74 | $501.19 | $676.08 |
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 $489.78 Median $660.69 Typical High $1,174.90 | Professional | None | $489.78 | $660.69 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $977.24 Typical High $7,943.28 | Facility | None | $54.95 | $977.24 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,380.38 Typical High $3,801.89 | Professional | None | $645.65 | $1,380.38 | $3,801.89 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $549.54 Median $912.01 Typical High $1,584.89 | Professional | None | $549.54 | $912.01 | $1,584.89 |
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 $269.15 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $269.15 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $53.70 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $380.19 | $436.52 | $467.74 |
Where Missouri sits
The same service costs 4.9 times more in Alaska than in West Virginia. 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
AK $5,557WV $1,144
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.