How much rates vary
Facilitymedian $2,512 · 10th to 90th $525 to $8,710Professionalmedian $1,413 · 10th to 90th $1,122 to $3,311
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 $1,348.96 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,348.96 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,162.28 Typical High $7,079.46 | Facility | None | $1,288.25 | $3,162.28 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,230.27 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $776.25 Typical High $1,318.26 | Professional | 62 · Two surgeons | $691.83 | $776.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $199.53 Typical High $338.84 | Professional | 80 · Assistant surgeon | $177.83 | $199.53 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $173.78 Typical High $295.12 | Professional | AS · PA/NP assist | $154.88 | $173.78 | $295.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,174.90 | $1,548.82 |
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 $1,071.52 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,412.54 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,318.26 Typical High $11,220.18 | Facility | None | $54.95 | $1,318.26 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $2,951.21 Typical High $8,128.31 | Professional | None | $1,479.11 | $2,951.21 | $8,128.31 |
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 $1,230.27 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,230.27 | $1,905.46 | $3,311.31 |
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 $575.44 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $575.44 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $269.15 Typical High $295.12 | Professional | 53 · Discontinued | $229.09 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,000.00 Typical High $1,096.48 | Professional | 54 · Surgery only | $870.96 | $1,000.00 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $173.78 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $134.90 Typical High $147.91 | Professional | 56 · Pre-op care only | $114.82 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $933.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $812.83 | $933.25 | $1,023.29 |
Where Missouri sits
The same service costs 9.9 times more in Alabama than in Maryland. 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 $18,241MD $1,851
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.