How much rates vary
Facilitymedian $2,754 · 10th to 90th $525 to $10,471Professionalmedian $1,698 · 10th to 90th $1,413 to $10,715
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 $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,479.11 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $3,981.07 Typical High $10,471.29 | Facility | None | $1,513.56 | $3,981.07 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,621.81 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,023.29 Typical High $1,513.56 | Professional | 62 · Two surgeons | $870.96 | $1,023.29 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $263.03 Typical High $389.05 | Professional | 80 · Assistant surgeon | $223.87 | $263.03 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $229.09 Typical High $338.84 | Professional | AS · PA/NP assist | $194.98 | $229.09 | $338.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,412.54 | $1,548.82 | $2,187.76 |
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 $1,412.54 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,621.81 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $10,964.78 | Facility | None | $54.95 | $1,380.38 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $10,715.19 Typical High $10,715.19 | Professional | None | $1,778.28 | $10,715.19 | $10,715.19 |
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 $1,412.54 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,412.54 | $2,041.74 | $3,548.13 |
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 $676.08 Median $707.95 Typical High $831.76 | Professional | 52 · Reduced service | $676.08 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $288.40 Typical High $331.13 | Professional | 53 · Discontinued | $275.42 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $213.80 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $138.04 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,174.90 |
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· 30th of 51
$1,738
AK $5,129TX $977
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.