How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $2,089 · 10th to 90th $1,445 to $10,715
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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,479.11 | $1,659.59 |
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 $1,513.56 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,513.56 | $1,905.46 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,202.26 Typical High $1,659.59 | Professional | 62 · Two surgeons | $933.25 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $302.00 Typical High $407.38 | Professional | 80 · Assistant surgeon | $239.88 | $302.00 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $263.03 Typical High $371.54 | Professional | AS · PA/NP assist | $208.93 | $263.03 | $371.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,412.54 | $1,584.89 | $2,187.76 |
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 $1,412.54 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,412.54 | $1,621.81 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,220.18 | Facility | None | $54.95 | $1,380.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $10,715.19 Typical High $10,715.19 | Professional | None | $1,778.28 | $10,715.19 | $10,715.19 |
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 $1,380.38 Median $2,089.30 Typical High $3,548.13 | Professional | None | $1,380.38 | $2,089.30 | $3,548.13 |
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 $676.08 Median $724.44 Typical High $812.83 | Professional | 52 · Reduced service | $676.08 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $288.40 Typical High $331.13 | Professional | 53 · Discontinued | $269.15 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,096.48 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,023.29 | $1,096.48 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $218.78 Typical High $245.47 | Professional | 55 · Aftercare only | $204.17 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $144.54 Typical High $165.96 | Professional | 56 · Pre-op care only | $134.90 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,023.29 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $954.99 | $1,023.29 | $1,148.15 |
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· 19th of 51
$2,089
AK $5,248TX $240
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.