How much rates vary
Facilitymedian $2,188 · 10th to 90th $676 to $7,762Professionalmedian $871 · 10th to 90th $603 to $1,862
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 $549.54 Median $691.83 Typical High $977.24 | Professional | None | $549.54 | $691.83 | $977.24 |
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 $616.60 Median $870.96 Typical High $1,174.90 | Professional | None | $616.60 | $870.96 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $549.54 Typical High $741.31 | Professional | 62 · Two surgeons | $389.05 | $549.54 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $141.25 Typical High $190.55 | Professional | 80 · Assistant surgeon | $100.00 | $141.25 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $123.03 Typical High $165.96 | Professional | AS · PA/NP assist | $87.10 | $123.03 | $165.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $851.14 | Professional | None | $549.54 | $602.56 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $3,311.31 | Facility | None | $758.58 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,348.96 | Professional | None | $602.56 | $676.08 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $2,754.23 Typical High $26,302.68 | Facility | None | $851.14 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,348.96 Typical High $9,772.37 | Professional | None | $724.44 | $1,348.96 | $9,772.37 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,584.89 | Professional | None | $630.96 | $891.25 | $1,584.89 |
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 $275.42 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $275.42 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $109.65 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $407.38 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $54.95 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $380.19 | $478.63 | $489.78 |
Where Missouri sits
The same service costs 5.4 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· 18th of 51
$1,023
AK $2,399UT $447
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.