How much rates vary
Facilitymedian $3,090 · 10th to 90th $537 to $25,119Professionalmedian $2,188 · 10th to 90th $1,698 to $13,183
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 $1,949.84 Median $5,623.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,659.59 | $1,778.28 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $10,964.78 Typical High $33,884.42 | Facility | None | $1,412.54 | $10,964.78 | $33,884.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,951.21 | Professional | None | $1,737.80 | $2,137.96 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,348.96 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,071.52 | $1,348.96 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $338.84 Typical High $467.74 | Professional | 80 · Assistant surgeon | $275.42 | $338.84 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $295.12 Typical High $407.38 | Professional | AS · PA/NP assist | $239.88 | $295.12 | $407.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,698.24 | $1,905.46 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $741.31 Typical High $4,786.30 | Facility | None | $489.78 | $741.31 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,737.80 | $1,949.84 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,584.89 Typical High $16,982.44 | Facility | None | $54.95 | $1,584.89 | $16,982.44 |
Medica Setting Professional Modifier None Typical Low $2,137.96 Median $13,182.57 Typical High $13,182.57 | Professional | None | $2,137.96 | $13,182.57 | $13,182.57 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $11,220.18 | Facility | None | $467.74 | $2,290.87 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,454.71 Typical High $4,365.16 | Professional | None | $1,698.24 | $2,454.71 | $4,365.16 |
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 $831.76 Median $870.96 Typical High $1,023.29 | Professional | 52 · Reduced service | $831.76 | $870.96 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $346.74 Typical High $407.38 | Professional | 53 · Discontinued | $331.13 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,288.25 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,258.93 | $1,288.25 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $257.04 Typical High $302.00 | Professional | 55 · Aftercare only | $251.19 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $173.78 Typical High $204.17 | Professional | 56 · Pre-op care only | $165.96 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,202.26 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,202.26 | $1,412.54 |
Where Missouri sits
The same service costs 5.4 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· 28th of 51
$2,188
AK $6,310TX $1,175
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.