How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,380 to $11,220Professionalmedian $1,445 · 10th to 90th $1,202 to $9,120
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 $2,290.87 Median $6,309.57 Typical High $13,182.57 | Facility | None | $2,290.87 | $6,309.57 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,174.90 | $1,258.93 | $1,412.54 |
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 $1,174.90 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,348.96 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $851.14 Typical High $1,288.25 | Professional | 62 · Two surgeons | $741.31 | $851.14 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $331.13 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $190.55 Typical High $288.40 | Professional | AS · PA/NP assist | $165.96 | $190.55 | $288.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,318.26 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,011.87 Typical High $7,585.78 | Facility | None | $707.95 | $5,011.87 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,348.96 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $6,165.95 Typical High $22,387.21 | Facility | None | $1,380.38 | $6,165.95 | $22,387.21 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $9,120.11 Typical High $9,120.11 | Professional | None | $1,513.56 | $9,120.11 | $9,120.11 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $19,054.61 | Facility | None | $1,174.90 | $5,248.07 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,737.80 | $3,019.95 |
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 $575.44 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $575.44 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $1,000.00 |
Where Missouri sits
The same service costs 25.7 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
$1,445
AK $5,129TX $200
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.