How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,202 to $9,550Professionalmedian $813 · 10th to 90th $589 to $5,888
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 $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $691.83 | Professional | None | $562.34 | $616.60 | $691.83 |
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 $616.60 Median $776.25 Typical High $1,023.29 | Professional | None | $616.60 | $776.25 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $489.78 Typical High $645.65 | Professional | 62 · Two surgeons | $389.05 | $489.78 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $123.03 Typical High $169.82 | Professional | 80 · Assistant surgeon | $97.72 | $123.03 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $109.65 Typical High $144.54 | Professional | AS · PA/NP assist | $85.11 | $109.65 | $144.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $851.14 | Professional | None | $537.03 | $602.56 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,905.46 Typical High $3,311.31 | Facility | None | $758.58 | $1,905.46 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,230.27 | Professional | None | $575.44 | $645.65 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $4,073.80 Typical High $26,302.68 | Facility | None | $870.96 | $4,073.80 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $724.44 | $5,888.44 | $5,888.44 |
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 $575.44 Median $891.25 Typical High $1,479.11 | Professional | None | $575.44 | $891.25 | $1,479.11 |
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 $281.84 Median $302.00 Typical High $346.74 | Professional | 52 · Reduced service | $281.84 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $138.04 | Professional | 53 · Discontinued | $112.20 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $69.18 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $478.63 |
Where Missouri sits
The same service costs 6.5 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· 20th of 51
$871
AK $2,455TX $380
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.