How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $1,905 · 10th to 90th $1,585 to $4,169
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 $1,778.28 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,778.28 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,819.70 | $2,041.74 |
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 $1,862.09 Typical High $2,951.21 | Professional | None | $1,584.89 | $1,862.09 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $295.12 Typical High $478.63 | Professional | 80 · Assistant surgeon | $251.19 | $295.12 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $257.04 Typical High $416.87 | Professional | AS · PA/NP assist | $218.78 | $257.04 | $416.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,584.89 | $2,290.87 |
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 $1,584.89 Median $1,778.28 Typical High $3,630.78 | Professional | None | $1,584.89 | $1,778.28 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,220.18 | Facility | None | $54.95 | $1,380.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $3,630.78 Typical High $11,481.54 | Professional | None | $1,905.46 | $3,630.78 | $11,481.54 |
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 $1,621.81 Median $2,238.72 Typical High $4,168.69 | Professional | None | $1,621.81 | $2,238.72 | $4,168.69 |
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 $724.44 Median $912.01 Typical High $933.25 | Professional | 52 · Reduced service | $724.44 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $363.08 Typical High $371.54 | Professional | 53 · Discontinued | $288.40 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,096.48 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $275.42 Typical High $281.84 | Professional | 55 · Aftercare only | $218.78 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $181.97 Typical High $186.21 | Professional | 56 · Pre-op care only | $144.54 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,288.25 | $1,288.25 |
Where Missouri sits
The same service costs 5.6 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· 27th of 51
$1,950
AK $6,310TX $1,122
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.