How much rates vary
Facilitymedian $2,692 · 10th to 90th $501 to $8,511Professionalmedian $5,129 · 10th to 90th $4,074 to $30,903
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 $5,011.87 Typical High $7,762.47 | Facility | None | $2,511.89 | $5,011.87 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $4,168.69 Typical High $4,786.30 | Professional | None | $3,890.45 | $4,168.69 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,168.69 Median $5,128.61 Typical High $7,079.46 | Professional | None | $4,168.69 | $5,128.61 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,630.27 Median $3,235.94 Typical High $4,365.16 | Professional | 62 · Two surgeons | $2,630.27 | $3,235.94 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $676.08 Median $812.83 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $676.08 | $812.83 | $1,122.02 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $588.84 Median $707.95 Typical High $977.24 | Professional | AS · PA/NP assist | $588.84 | $707.95 | $977.24 |
BCBS Kansas City Setting Professional Modifier None Typical Low $4,073.80 Median $4,466.84 Typical High $6,165.95 | Professional | None | $4,073.80 | $4,466.84 | $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 $4,073.80 Median $4,677.35 Typical High $7,943.28 | Professional | None | $4,073.80 | $4,677.35 | $7,943.28 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $11,220.18 | Facility | None | $54.95 | $1,348.96 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $5,011.87 Median $30,902.95 Typical High $30,902.95 | Professional | None | $5,011.87 | $30,902.95 | $30,902.95 |
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 $4,073.80 Median $5,495.41 Typical High $10,232.93 | Professional | None | $4,073.80 | $5,495.41 | $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 $2,089.30 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,949.84 | $2,089.30 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $831.76 Typical High $954.99 | Professional | 53 · Discontinued | $794.33 | $831.76 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,090.30 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,951.21 | $3,090.30 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $616.60 Typical High $707.95 | Professional | 55 · Aftercare only | $588.84 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $416.87 Typical High $478.63 | Professional | 56 · Pre-op care only | $389.05 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $2,884.03 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,754.23 | $2,884.03 | $3,311.31 |
Where Missouri sits
The same service costs 20.9 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
$5,129
AK $14,125TX $676
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.