How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,175 to $10,471Professionalmedian $1,000 · 10th to 90th $741 to $8,318
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 $2,089.30 Median $6,165.95 Typical High $12,589.25 | Facility | None | $2,089.30 | $6,165.95 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $870.96 | Professional | None | $707.95 | $776.25 | $870.96 |
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 $758.58 Median $912.01 Typical High $1,258.93 | Professional | None | $758.58 | $912.01 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $575.44 Typical High $794.33 | Professional | 62 · Two surgeons | $478.63 | $575.44 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $147.91 Typical High $204.17 | Professional | 80 · Assistant surgeon | $120.23 | $147.91 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $177.83 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $177.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,148.15 | Professional | None | $741.31 | $812.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,715.35 Typical High $4,466.84 | Facility | None | $912.01 | $3,715.35 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,513.56 | Professional | None | $724.44 | $831.76 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $5,128.61 Typical High $13,489.63 | Facility | None | $933.25 | $5,128.61 | $13,489.63 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $8,317.64 Typical High $8,317.64 | Professional | None | $912.01 | $8,317.64 | $8,317.64 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,862.09 | Professional | None | $724.44 | $1,047.13 | $1,862.09 |
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 $354.81 Median $371.54 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $147.91 Typical High $173.78 | Professional | 53 · Discontinued | $141.25 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $537.03 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $74.13 Typical High $87.10 | Professional | 56 · Pre-op care only | $70.79 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $602.56 |
Where Missouri sits
The same service costs 25.1 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· 23rd of 51
$1,047
AK $3,090TX $123
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.