How much rates vary
Facilitymedian $2,818 · 10th to 90th $525 to $9,772Professionalmedian $4,786 · 10th to 90th $3,890 to $31,623
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 $2,511.89 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,511.89 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $4,073.80 Typical High $4,677.35 | Professional | None | $3,890.45 | $4,073.80 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,715.35 Typical High $8,912.51 | Facility | None | $1,412.54 | $3,715.35 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $6,918.31 | Professional | None | $3,630.78 | $4,466.84 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,290.87 Median $2,818.38 Typical High $4,365.16 | Professional | 62 · Two surgeons | $2,290.87 | $2,818.38 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $707.95 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $575.44 | $707.95 | $1,096.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $616.60 Typical High $954.99 | Professional | AS · PA/NP assist | $512.86 | $616.60 | $954.99 |
BCBS Kansas City Setting Professional Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $6,165.95 | Professional | None | $3,981.07 | $4,365.16 | $6,165.95 |
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 $3,981.07 Median $4,466.84 Typical High $7,762.47 | Professional | None | $3,981.07 | $4,466.84 | $7,762.47 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,481.54 | Facility | None | $54.95 | $1,380.38 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $4,897.79 Median $31,622.78 Typical High $31,622.78 | Professional | None | $4,897.79 | $31,622.78 | $31,622.78 |
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 $3,981.07 Median $5,370.32 Typical High $10,232.93 | Professional | None | $3,981.07 | $5,370.32 | $10,232.93 |
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 $1,949.84 Median $1,995.26 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,949.84 | $1,995.26 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $812.83 Typical High $954.99 | Professional | 53 · Discontinued | $776.25 | $812.83 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $3,019.95 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,884.03 | $3,019.95 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $602.56 Typical High $707.95 | Professional | 55 · Aftercare only | $588.84 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $398.11 Typical High $467.74 | Professional | 56 · Pre-op care only | $389.05 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,818.38 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,818.38 | $3,311.31 |
Where Missouri sits
The same service costs 21.9 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· 27th of 51
$4,786
AK $14,125TX $646
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.