How much rates vary
Facilitymedian $3,467 · 10th to 90th $646 to $10,965Professionalmedian $1,047 · 10th to 90th $759 to $5,623
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 $5,623.41 Typical High $13,803.84 | Facility | None | $2,511.89 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $870.96 | Professional | None | $724.44 | $776.25 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $4,265.80 Typical High $11,748.98 | Facility | None | $1,412.54 | $4,265.80 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,348.96 | Professional | None | $776.25 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $630.96 Typical High $851.14 | Professional | 62 · Two surgeons | $489.78 | $630.96 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $162.18 Typical High $213.80 | Professional | 80 · Assistant surgeon | $125.89 | $162.18 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $141.25 Typical High $186.21 | Professional | AS · PA/NP assist | $109.65 | $141.25 | $186.21 |
BCBS Kansas City Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,148.15 | Professional | None | $741.31 | $831.76 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $12,302.69 | Facility | None | $501.19 | $812.83 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,548.82 | Professional | None | $741.31 | $851.14 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $2,398.83 Typical High $10,232.93 | Facility | None | $562.34 | $2,398.83 | $10,232.93 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $5,623.41 Typical High $5,623.41 | Professional | None | $933.25 | $5,623.41 | $5,623.41 |
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 $741.31 Median $1,047.13 Typical High $1,862.09 | Professional | None | $741.31 | $1,047.13 | $1,862.09 |
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 $363.08 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $144.54 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $537.03 | $616.60 |
Where Missouri sits
The same service costs 5.9 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· 22nd of 51
$1,047
AK $3,162TX $537
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.