How much rates vary
Facilitymedian $3,981 · 10th to 90th $871 to $17,378Professionalmedian $1,622 · 10th to 90th $1,202 to $11,749
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 $5,623.41 Typical High $9,549.93 | Facility | None | $1,698.24 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,258.93 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $6,165.95 Typical High $22,908.68 | Facility | None | $1,412.54 | $6,165.95 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,479.11 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $1,318.26 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $239.88 Typical High $338.84 | Professional | 80 · Assistant surgeon | $194.98 | $239.88 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $208.93 Typical High $295.12 | Professional | AS · PA/NP assist | $169.82 | $208.93 | $295.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,348.96 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $741.31 Typical High $2,691.53 | Facility | None | $489.78 | $741.31 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,380.38 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,818.38 Typical High $12,589.25 | Facility | None | $54.95 | $2,818.38 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $11,748.98 Typical High $11,748.98 | Professional | None | $1,513.56 | $11,748.98 | $11,748.98 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,981.07 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,737.80 | $3,090.30 |
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 $588.84 Median $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $588.84 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $245.47 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $891.25 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $177.83 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $144.54 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $831.76 | $870.96 | $1,000.00 |
Where Missouri sits
The same service costs 26.3 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· 25th of 51
$1,660
AK $5,248TX $200
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.