How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,288 to $10,471Professionalmedian $1,288 · 10th to 90th $933 to $3,090
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 $2,511.89 Median $6,309.57 Typical High $10,715.19 | Facility | None | $2,511.89 | $6,309.57 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $2,754.23 | Professional | None | $831.76 | $1,071.52 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $9,549.93 | Facility | None | $1,288.25 | $3,890.45 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,819.70 | Professional | None | $933.25 | $1,288.25 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,905.46 Typical High $2,754.23 | Professional | 50 · Both sides | $1,380.38 | $1,905.46 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $812.83 Typical High $1,148.15 | Professional | 62 · Two surgeons | $588.84 | $812.83 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $204.17 Typical High $288.40 | Professional | 80 · Assistant surgeon | $147.91 | $204.17 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $177.83 Typical High $257.04 | Professional | AS · PA/NP assist | $128.82 | $177.83 | $257.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,288.25 | Professional | None | $831.76 | $912.01 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $5,011.87 Typical High $7,585.78 | Facility | None | $912.01 | $5,011.87 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $2,089.30 | Professional | None | $912.01 | $1,047.13 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $4,677.35 Typical High $13,489.63 | Facility | None | $1,258.93 | $4,677.35 | $13,489.63 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,089.30 Typical High $6,760.83 | Professional | None | $1,122.02 | $2,089.30 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $9,772.37 | Facility | None | $1,258.93 | $3,981.07 | $9,772.37 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,398.83 | Professional | None | $977.24 | $1,412.54 | $2,398.83 |
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 $416.87 Median $524.81 Typical High $537.03 | Professional | 52 · Reduced service | $416.87 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $208.93 Typical High $213.80 | Professional | 53 · Discontinued | $165.96 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $794.33 Typical High $812.83 | Professional | 54 · Surgery only | $630.96 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $158.49 Typical High $162.18 | Professional | 55 · Aftercare only | $125.89 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $104.71 Typical High $107.15 | Professional | 56 · Pre-op care only | $83.18 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $741.31 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $588.84 | $741.31 | $758.58 |
Where Missouri sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.