How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,479 to $12,882Professionalmedian $2,089 · 10th to 90th $1,549 to $13,804
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 $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,737.80 | $1,862.09 | $2,089.30 |
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 $1,548.82 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,548.82 | $1,949.84 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,230.27 Typical High $1,778.28 | Professional | 62 · Two surgeons | $977.24 | $1,230.27 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $316.23 Typical High $457.09 | Professional | 80 · Assistant surgeon | $245.47 | $316.23 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $269.15 Typical High $398.11 | Professional | AS · PA/NP assist | $213.80 | $269.15 | $398.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,659.59 | $1,819.70 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $5,248.07 | Facility | None | $1,202.26 | $3,801.89 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $3,630.78 | Professional | None | $1,698.24 | $1,949.84 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $26,302.68 | Facility | None | $1,513.56 | $4,466.84 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $2,089.30 Median $13,803.84 Typical High $13,803.84 | Professional | None | $2,089.30 | $13,803.84 | $13,803.84 |
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 $1,737.80 Median $2,630.27 Typical High $4,466.84 | Professional | None | $1,737.80 | $2,630.27 | $4,466.84 |
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 $870.96 Median $912.01 Typical High $1,047.13 | Professional | 52 · Reduced service | $870.96 | $912.01 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $363.08 Typical High $416.87 | Professional | 53 · Discontinued | $346.74 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $269.15 Typical High $316.23 | Professional | 55 · Aftercare only | $257.04 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $181.97 Typical High $208.93 | Professional | 56 · Pre-op care only | $173.78 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,258.93 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,258.93 | $1,479.11 |
Where Missouri sits
The same service costs 3.0 times more in Alaska than in Delaware. 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 $13,579DE $4,544
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.