How much rates vary
Facilitymedian $2,138 · 10th to 90th $562 to $5,754Professionalmedian $741 · 10th to 90th $575 to $4,677
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 $724.44 Median $4,897.79 Typical High $7,762.47 | Facility | None | $724.44 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $691.83 | Professional | None | $562.34 | $588.84 | $691.83 |
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 $977.24 | Professional | None | $562.34 | $707.95 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $446.68 Typical High $602.56 | Professional | 62 · Two surgeons | $354.81 | $446.68 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $112.20 Typical High $154.88 | Professional | 80 · Assistant surgeon | $89.13 | $112.20 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $97.72 Typical High $134.90 | Professional | AS · PA/NP assist | $79.43 | $97.72 | $134.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $933.25 | Professional | None | $588.84 | $660.69 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $660.69 Typical High $2,691.53 | Facility | None | $489.78 | $660.69 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,174.90 | Professional | None | $575.44 | $645.65 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $5,754.40 | Facility | None | $54.95 | $1,380.38 | $5,754.40 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $4,677.35 Typical High $4,677.35 | Professional | None | $707.95 | $4,677.35 | $4,677.35 |
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 $575.44 Median $812.83 Typical High $1,479.11 | Professional | None | $575.44 | $812.83 | $1,479.11 |
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 $281.84 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $281.84 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $112.20 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $436.52 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $56.23 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $407.38 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $407.38 | $478.63 |
Where Missouri sits
The same service costs 5.0 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· 27th of 51
$741
AK $2,138TX $427
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.