How much rates vary
Facilitymedian $2,692 · 10th to 90th $537 to $10,471Professionalmedian $1,660 · 10th to 90th $1,148 to $3,311
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 $2,041.74 Median $5,623.41 Typical High $11,748.98 | Facility | None | $2,041.74 | $5,623.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,318.26 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,023.29 Typical High $1,412.54 | Professional | 62 · Two surgeons | $776.25 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $263.03 Typical High $363.08 | Professional | 80 · Assistant surgeon | $199.53 | $263.03 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $229.09 Typical High $316.23 | Professional | AS · PA/NP assist | $173.78 | $229.09 | $316.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,148.15 | $1,584.89 |
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 $1,148.15 Median $1,318.26 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,318.26 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,288.25 Typical High $9,772.37 | Facility | None | $54.95 | $1,288.25 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $2,570.40 Typical High $8,511.38 | Professional | None | $1,412.54 | $2,570.40 | $8,511.38 |
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 $1,202.26 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,737.80 | $3,019.95 |
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 $524.81 Median $660.69 Typical High $676.08 | Professional | 52 · Reduced service | $524.81 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $263.03 Typical High $269.15 | Professional | 53 · Discontinued | $208.93 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $977.24 Typical High $1,000.00 | Professional | 54 · Surgery only | $776.25 | $977.24 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $194.98 Typical High $199.53 | Professional | 55 · Aftercare only | $154.88 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $131.83 Typical High $134.90 | Professional | 56 · Pre-op care only | $104.71 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $912.01 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $724.44 | $912.01 | $933.25 |
Where Missouri sits
The same service costs 5.8 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· 13th of 51
$1,820
AK $4,571UT $794
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.