How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,471Professionalmedian $1,514 · 10th to 90th $1,259 to $9,772
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 $1,584.89 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,584.89 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,348.96 | $1,513.56 |
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 $1,230.27 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,479.11 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $1,348.96 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $234.42 Typical High $338.84 | Professional | 80 · Assistant surgeon | $199.53 | $234.42 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $208.93 Typical High $295.12 | Professional | AS · PA/NP assist | $169.82 | $208.93 | $295.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,412.54 | $1,949.84 |
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 $1,288.25 Median $1,479.11 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,479.11 | $2,691.53 |
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 $1,548.82 Median $9,772.37 Typical High $9,772.37 | Professional | None | $1,548.82 | $9,772.37 | $9,772.37 |
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 $1,288.25 Median $1,819.70 Typical High $3,235.94 | Professional | None | $1,288.25 | $1,819.70 | $3,235.94 |
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 $616.60 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $251.19 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $1,047.13 |
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
$1,549
AK $4,677TX $891
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.