How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,471Professionalmedian $1,698 · 10th to 90th $1,202 to $3,548
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 $1,380.38 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,380.38 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,412.54 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,964.78 | Facility | None | $1,412.54 | $3,801.89 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,698.24 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,511.89 Typical High $3,548.13 | Professional | 50 · Both sides | $1,862.09 | $2,511.89 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $269.15 Typical High $380.19 | Professional | 80 · Assistant surgeon | $199.53 | $269.15 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $234.42 Typical High $331.13 | Professional | AS · PA/NP assist | $173.78 | $234.42 | $331.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,202.26 | $1,698.24 |
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 $1,202.26 Median $1,380.38 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,380.38 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $9,772.37 | Facility | None | $54.95 | $1,348.96 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $2,754.23 Typical High $9,549.93 | Professional | None | $1,479.11 | $2,754.23 | $9,549.93 |
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 $3,162.28 | Professional | None | $1,288.25 | $1,819.70 | $3,162.28 |
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 $549.54 Median $691.83 Typical High $707.95 | Professional | 52 · Reduced service | $549.54 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $275.42 Typical High $281.84 | Professional | 53 · Discontinued | $218.78 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,047.13 Typical High $1,071.52 | Professional | 54 · Surgery only | $831.76 | $1,047.13 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $208.93 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $138.04 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $977.24 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $776.25 | $977.24 | $1,000.00 |
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· 15th of 51
$1,820
AK $4,898TX $832
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.