How much rates vary
Facilitymedian $2,692 · 10th to 90th $676 to $7,943Professionalmedian $912 · 10th to 90th $646 to $1,820
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 $1,698.24 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,122.02 | Professional | None | $588.84 | $741.31 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,230.27 | Professional | None | $691.83 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $575.44 Typical High $776.25 | Professional | 62 · Two surgeons | $436.52 | $575.44 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $144.54 Typical High $194.98 | Professional | 80 · Assistant surgeon | $109.65 | $144.54 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $125.89 Typical High $173.78 | Professional | AS · PA/NP assist | $95.50 | $125.89 | $173.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $912.01 | Professional | None | $588.84 | $645.65 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,311.31 Typical High $4,365.16 | Facility | None | $758.58 | $3,311.31 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,445.44 | Professional | None | $645.65 | $724.44 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $3,801.89 Typical High $26,302.68 | Facility | None | $870.96 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,445.44 Typical High $19,054.61 | Professional | None | $776.25 | $1,445.44 | $19,054.61 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,698.24 | Professional | None | $676.08 | $1,000.00 | $1,698.24 |
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 $295.12 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $295.12 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $147.91 Typical High $151.36 | Professional | 53 · Discontinued | $117.49 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $549.54 Typical High $562.34 | Professional | 54 · Surgery only | $436.52 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $109.65 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $58.88 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $512.86 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $407.38 | $512.86 | $524.81 |
Where Missouri sits
The same service costs 5.1 times more in Wisconsin 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
WI $10,170MT $2,000
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.