How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,471Professionalmedian $1,738 · 10th to 90th $1,445 to $10,965
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 $1,412.54 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,513.56 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,698.24 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,071.52 Typical High $1,548.82 | Professional | 62 · Two surgeons | $912.01 | $1,071.52 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $269.15 Typical High $398.11 | Professional | 80 · Assistant surgeon | $229.09 | $269.15 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $346.74 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $346.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,584.89 | $2,290.87 |
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 $1,445.44 Median $1,659.59 Typical High $3,019.95 | Professional | None | $1,445.44 | $1,659.59 | $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 $1,819.70 Median $10,964.78 Typical High $10,964.78 | Professional | None | $1,819.70 | $10,964.78 | $10,964.78 |
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 $1,445.44 Median $2,089.30 Typical High $3,715.35 | Professional | None | $1,445.44 | $2,089.30 | $3,715.35 |
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 $707.95 Median $741.31 Typical High $851.14 | Professional | 52 · Reduced service | $707.95 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $295.12 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $147.91 Typical High $169.82 | Professional | 56 · Pre-op care only | $141.25 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,202.26 |
Where Missouri sits
The same service costs 20.9 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· 31st of 51
$1,778
AK $5,129TX $245
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.