How much rates vary
Facilitymedian $2,818 · 10th to 90th $525 to $10,965Professionalmedian $5,754 · 10th to 90th $3,388 to $35,481
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 $2,511.89 Median $5,623.41 Typical High $7,762.47 | Facility | None | $2,511.89 | $5,623.41 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $4,897.79 Typical High $5,495.41 | Professional | None | $4,570.88 | $4,897.79 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,412.54 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,388.44 Median $5,370.32 Typical High $8,128.31 | Professional | None | $3,388.44 | $5,370.32 | $8,128.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,137.96 Median $3,388.44 Typical High $5,128.61 | Professional | 62 · Two surgeons | $2,137.96 | $3,388.44 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $870.96 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $537.03 | $870.96 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $758.58 Typical High $1,122.02 | Professional | AS · PA/NP assist | $467.74 | $758.58 | $1,122.02 |
BCBS Kansas City Setting Professional Modifier None Typical Low $4,677.35 Median $5,128.61 Typical High $7,413.10 | Professional | None | $4,677.35 | $5,128.61 | $7,413.10 |
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 $4,677.35 Median $5,370.32 Typical High $9,549.93 | Professional | None | $4,677.35 | $5,370.32 | $9,549.93 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $12,022.64 | Facility | None | $54.95 | $1,380.38 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $5,248.07 Median $35,481.34 Typical High $35,481.34 | Professional | None | $5,248.07 | $35,481.34 | $35,481.34 |
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 $4,677.35 Median $7,244.36 Typical High $11,748.98 | Professional | None | $4,677.35 | $7,244.36 | $11,748.98 |
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 $2,238.72 Median $2,454.71 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,238.72 | $2,454.71 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $977.24 Typical High $1,096.48 | Professional | 53 · Discontinued | $912.01 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $3,715.35 Typical High $4,073.80 | Professional | 54 · Surgery only | $3,388.44 | $3,715.35 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $741.31 Typical High $831.76 | Professional | 55 · Aftercare only | $676.08 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $489.78 Typical High $549.54 | Professional | 56 · Pre-op care only | $457.09 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,467.37 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,467.37 | $3,801.89 |
Where Missouri sits
The same service costs 21.9 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· 30th of 51
$5,754
AK $16,596TX $759
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.