How much rates vary
Facilitymedian $2,630 · 10th to 90th $525 to $8,710Professionalmedian $1,380 · 10th to 90th $1,000 to $8,710
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 $1,412.54 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,412.54 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,202.26 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,548.13 Typical High $7,762.47 | Facility | None | $1,412.54 | $3,548.13 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,258.93 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $794.33 Typical High $1,202.26 | Professional | 62 · Two surgeons | $630.96 | $794.33 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $199.53 Typical High $309.03 | Professional | 80 · Assistant surgeon | $158.49 | $199.53 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $173.78 Typical High $269.15 | Professional | AS · PA/NP assist | $141.25 | $173.78 | $269.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,148.15 | $1,288.25 | $1,778.28 |
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 $1,148.15 Median $1,318.26 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,318.26 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,318.26 Typical High $9,772.37 | Facility | None | $54.95 | $1,318.26 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $8,709.64 Typical High $8,709.64 | Professional | None | $1,412.54 | $8,709.64 | $8,709.64 |
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 $1,148.15 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,148.15 | $1,621.81 | $2,951.21 |
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 $562.34 Median $588.84 Typical High $676.08 | Professional | 52 · Reduced service | $562.34 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $831.76 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $134.90 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $831.76 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $776.25 | $831.76 | $954.99 |
Where Missouri sits
The same service costs 5.9 times more in Alabama 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
AL $10,682MD $1,821
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.