How much rates vary
Facilitymedian $2,818 · 10th to 90th $617 to $10,233Professionalmedian $2,089 · 10th to 90th $1,660 to $12,589
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 $1,995.26 Median $5,754.40 Typical High $12,589.25 | Facility | None | $1,995.26 | $5,754.40 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,778.28 | $2,238.72 |
Ambetter Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $1,778.28 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,778.28 | $2,089.30 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,318.26 Typical High $1,819.70 | Professional | 62 · Two surgeons | $1,122.02 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $331.13 Typical High $457.09 | Professional | 80 · Assistant surgeon | $281.84 | $331.13 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $288.40 Typical High $398.11 | Professional | AS · PA/NP assist | $245.47 | $288.40 | $398.11 |
BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,621.81 | $1,778.28 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $707.95 Typical High $2,691.53 | Facility | None | $489.78 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $3,467.37 | Professional | None | $1,659.59 | $1,905.46 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $2,511.89 Typical High $11,220.18 | Facility | None | $562.34 | $2,511.89 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $2,041.74 Median $12,589.25 Typical High $12,589.25 | Professional | None | $2,041.74 | $12,589.25 | $12,589.25 |
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 $1,659.59 Median $2,398.83 Typical High $4,168.69 | Professional | None | $1,659.59 | $2,398.83 | $4,168.69 |
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 $794.33 Median $851.14 Typical High $977.24 | Professional | 52 · Reduced service | $794.33 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $338.84 Typical High $389.05 | Professional | 53 · Discontinued | $316.23 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,288.25 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,202.26 | $1,288.25 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $257.04 Typical High $288.40 | Professional | 55 · Aftercare only | $239.88 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $169.82 Typical High $194.98 | Professional | 56 · Pre-op care only | $158.49 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,202.26 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,202.26 | $1,348.96 |
Where Missouri sits
The same service costs 6.4 times more in Alaska than in Maryland. 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.
Physician feeFacility fee
AK $15,221MD $2,382
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.