How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,471Professionalmedian $1,660 · 10th to 90th $1,349 to $12,023
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 $1,659.59 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,659.59 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,412.54 | $1,584.89 |
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 $1,380.38 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,584.89 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,000.00 Typical High $1,445.44 | Professional | 62 · Two surgeons | $851.14 | $1,000.00 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $251.19 Typical High $371.54 | Professional | 80 · Assistant surgeon | $218.78 | $251.19 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $218.78 Typical High $323.59 | Professional | AS · PA/NP assist | $190.55 | $218.78 | $323.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,348.96 | $1,479.11 | $2,041.74 |
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 $1,348.96 Median $1,548.82 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,548.82 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $10,471.29 | Facility | None | $54.95 | $1,348.96 | $10,471.29 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $12,022.64 Typical High $12,022.64 | Professional | None | $1,698.24 | $12,022.64 | $12,022.64 |
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 $1,348.96 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,949.84 | $3,388.44 |
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 $645.65 Median $691.83 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $263.03 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,047.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $158.49 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $977.24 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $977.24 | $1,122.02 |
Where Missouri sits
The same service costs 5.2 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· 29th of 51
$1,698
AK $4,898TX $933
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.