How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,715Professionalmedian $2,089 · 10th to 90th $1,479 to $3,981
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 $1,659.59 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,659.59 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,698.24 | $1,905.46 |
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 $1,584.89 Median $2,041.74 Typical High $2,884.03 | Professional | None | $1,584.89 | $2,041.74 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $3,090.30 Typical High $4,365.16 | Professional | 50 · Both sides | $2,398.83 | $3,090.30 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,288.25 Typical High $1,819.70 | Professional | 62 · Two surgeons | $1,000.00 | $1,288.25 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $331.13 Typical High $467.74 | Professional | 80 · Assistant surgeon | $251.19 | $331.13 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $288.40 Typical High $407.38 | Professional | AS · PA/NP assist | $223.87 | $288.40 | $407.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,318.26 | $1,445.44 | $2,041.74 |
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 $1,445.44 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,445.44 | $1,659.59 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $10,715.19 | Facility | None | $54.95 | $1,348.96 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $3,311.31 Typical High $10,715.19 | Professional | None | $1,778.28 | $3,311.31 | $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 $1,548.82 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,548.82 | $2,238.72 | $3,801.89 |
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 $660.69 Median $831.76 Typical High $851.14 | Professional | 52 · Reduced service | $660.69 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $331.13 Typical High $338.84 | Professional | 53 · Discontinued | $263.03 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,258.93 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,000.00 | $1,258.93 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $251.19 Typical High $257.04 | Professional | 55 · Aftercare only | $199.53 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $165.96 Typical High $169.82 | Professional | 56 · Pre-op care only | $131.83 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,174.90 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $933.25 | $1,174.90 | $1,202.26 |
Where Missouri sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 16th of 51
$2,188
AK $5,888UT $1,000
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.