How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,288 to $10,471Professionalmedian $1,622 · 10th to 90th $1,202 to $4,169
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 $1,621.81 Median $5,623.41 Typical High $8,709.64 | Facility | None | $1,621.81 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,380.38 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,584.89 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $257.04 Typical High $416.87 | Professional | 80 · Assistant surgeon | $194.98 | $257.04 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $223.87 Typical High $363.08 | Professional | AS · PA/NP assist | $169.82 | $223.87 | $363.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,621.81 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,630.78 Typical High $4,365.16 | Facility | None | $912.01 | $3,630.78 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,951.21 | Professional | None | $1,148.15 | $1,479.11 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $4,073.80 Typical High $26,302.68 | Facility | None | $1,348.96 | $4,073.80 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $11,220.18 | Professional | None | $1,862.09 | $8,709.64 | $11,220.18 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,445.44 | $2,089.30 | $3,630.78 |
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 $549.54 Median $691.83 Typical High $812.83 | Professional | 52 · Reduced service | $549.54 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $275.42 Typical High $323.59 | Professional | 53 · Discontinued | $218.78 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $162.18 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $138.04 Typical High $162.18 | Professional | 56 · Pre-op care only | $109.65 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $977.24 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $758.58 | $977.24 | $1,122.02 |
Where Missouri sits
The same service costs 5.2 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· 28th of 51
$1,778
AK $6,026TX $1,148
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.