How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,471Professionalmedian $2,884 · 10th to 90th $2,344 to $17,783
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 $2,290.87 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,290.87 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $2,754.23 | Professional | None | $2,290.87 | $2,454.71 | $2,754.23 |
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 $2,344.23 Median $2,884.03 Typical High $3,981.07 | Professional | None | $2,344.23 | $2,884.03 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,479.11 Median $1,819.70 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,479.11 | $1,819.70 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $457.09 Typical High $630.96 | Professional | 80 · Assistant surgeon | $380.19 | $457.09 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $407.38 Typical High $575.44 | Professional | AS · PA/NP assist | $331.13 | $407.38 | $575.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,344.23 Median $2,570.40 Typical High $3,548.13 | Professional | None | $2,344.23 | $2,570.40 | $3,548.13 |
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 $2,344.23 Median $2,691.53 Typical High $4,897.79 | Professional | None | $2,344.23 | $2,691.53 | $4,897.79 |
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 $2,884.03 Median $17,782.79 Typical High $17,782.79 | Professional | None | $2,884.03 | $17,782.79 | $17,782.79 |
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 $2,344.23 Median $3,388.44 Typical High $5,888.44 | Professional | None | $2,344.23 | $3,388.44 | $5,888.44 |
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 $1,148.15 Median $1,202.26 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,148.15 | $1,202.26 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $478.63 Typical High $549.54 | Professional | 53 · Discontinued | $457.09 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,819.70 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,698.24 | $1,819.70 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $363.08 Typical High $416.87 | Professional | 55 · Aftercare only | $338.84 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $239.88 Typical High $275.42 | Professional | 56 · Pre-op care only | $229.09 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,698.24 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,698.24 | $1,949.84 |
Where Missouri sits
The same service costs 21.4 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· 30th of 51
$2,884
AK $8,318TX $389
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.