How much rates vary
Facilitymedian $2,042 · 10th to 90th $575 to $5,370Professionalmedian $724 · 10th to 90th $537 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 $676.08 Median $4,897.79 Typical High $7,762.47 | Facility | None | $676.08 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $630.96 | Professional | None | $524.81 | $562.34 | $630.96 |
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 $562.34 Median $707.95 Typical High $933.25 | Professional | None | $562.34 | $707.95 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $446.68 Typical High $588.84 | Professional | 62 · Two surgeons | $354.81 | $446.68 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $112.20 Typical High $151.36 | Professional | 80 · Assistant surgeon | $89.13 | $112.20 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $100.00 Typical High $131.83 | Professional | AS · PA/NP assist | $77.62 | $100.00 | $131.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $851.14 | Professional | None | $549.54 | $616.60 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $1,659.59 | Facility | None | $478.63 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $1,047.13 | Professional | None | $537.03 | $602.56 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $4,570.88 | Facility | None | $54.95 | $1,380.38 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $4,168.69 Typical High $4,168.69 | Professional | None | $676.08 | $4,168.69 | $4,168.69 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,380.38 | Professional | None | $524.81 | $758.58 | $1,380.38 |
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 $263.03 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $263.03 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $104.71 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $478.63 | Professional | 54 · Surgery only | $389.05 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $95.50 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $446.68 |
Where Missouri sits
The same service costs 5.5 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· 24th of 51
$741
AK $2,188TX $398
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.