How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,175 to $15,488Professionalmedian $724 · 10th to 90th $537 to $4,571
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 $758.58 Median $6,309.57 Typical High $13,803.84 | Facility | None | $758.58 | $6,309.57 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $870.96 | Professional | None | $524.81 | $562.34 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $831.76 | Professional | None | $537.03 | $776.25 | $831.76 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | 50 · Both sides | $933.25 | $1,258.93 | $1,258.93 |
Ambetter Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | AS · PA/NP assist | $169.82 | $169.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $6,165.95 Typical High $12,302.69 | Facility | None | $1,479.11 | $6,165.95 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $933.25 | Professional | None | $562.34 | $676.08 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,023.29 Typical High $1,412.54 | Professional | 50 · Both sides | $831.76 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $426.58 Typical High $588.84 | Professional | 62 · Two surgeons | $354.81 | $426.58 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $109.65 Typical High $147.91 | Professional | 80 · Assistant surgeon | $89.13 | $109.65 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $95.50 Typical High $131.83 | Professional | AS · PA/NP assist | $77.62 | $95.50 | $131.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $851.14 | Professional | None | $549.54 | $616.60 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $4,168.69 Typical High $11,220.18 | Facility | None | $1,348.96 | $4,168.69 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $1,096.48 | Professional | None | $537.03 | $602.56 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $5,888.44 Typical High $26,302.68 | Facility | None | $831.76 | $5,888.44 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $4,570.88 Typical High $4,570.88 | Professional | None | $660.69 | $4,570.88 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $5,754.40 Typical High $12,302.69 | Facility | None | $1,023.29 | $5,754.40 | $12,302.69 |
United Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,380.38 | Professional | None | $524.81 | $758.58 | $1,380.38 |
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 $263.03 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $263.03 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $104.71 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $478.63 | Professional | 54 · Surgery only | $389.05 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $81.28 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $446.68 |
Where Missouri sits
The same service costs 6.0 times more in Wisconsin than in Montana. 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.
Physician feeFacility fee
WI $11,096MT $1,846
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.