How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,202 to $7,943Professionalmedian $1,230 · 10th to 90th $1,023 to $8,128
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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,096.48 | $1,230.27 |
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 $977.24 Median $1,174.90 Typical High $1,737.80 | Professional | None | $977.24 | $1,174.90 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $741.31 Typical High $1,096.48 | Professional | 62 · Two surgeons | $616.60 | $741.31 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $190.55 Typical High $281.84 | Professional | 80 · Assistant surgeon | $154.88 | $190.55 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $165.96 Typical High $245.47 | Professional | AS · PA/NP assist | $134.90 | $165.96 | $245.47 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,174.90 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,187.76 | Facility | None | $602.56 | $1,778.28 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,174.90 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $3,801.89 Typical High $16,218.10 | Facility | None | $1,148.15 | $3,801.89 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $8,128.31 Typical High $8,128.31 | Professional | None | $1,258.93 | $8,128.31 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,479.11 | $2,630.27 |
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 $512.86 Median $537.03 Typical High $616.60 | Professional | 52 · Reduced service | $512.86 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $245.47 | Professional | 53 · Discontinued | $204.17 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $758.58 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $186.21 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $123.03 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $870.96 |
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· 31st of 51
$1,288
AK $3,981TX $759
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.