How much rates vary
Facilitymedian $2,692 · 10th to 90th $537 to $10,471Professionalmedian $1,479 · 10th to 90th $1,096 to $3,162
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 $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,258.93 | $2,511.89 |
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 $1,174.90 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,479.11 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $912.01 Typical High $1,318.26 | Professional | 62 · Two surgeons | $741.31 | $912.01 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $234.42 Typical High $338.84 | Professional | 80 · Assistant surgeon | $186.21 | $234.42 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $204.17 Typical High $295.12 | Professional | AS · PA/NP assist | $165.96 | $204.17 | $295.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,096.48 | $1,513.56 |
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 $1,096.48 Median $1,258.93 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,258.93 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,288.25 Typical High $8,912.51 | Facility | None | $54.95 | $1,288.25 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $2,454.71 Typical High $10,000.00 | Professional | None | $1,318.26 | $2,454.71 | $10,000.00 |
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 $1,148.15 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,621.81 | $2,884.03 |
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 $501.19 Median $616.60 Typical High $630.96 | Professional | 52 · Reduced service | $501.19 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $251.19 Typical High $257.04 | Professional | 53 · Discontinued | $199.53 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $933.25 Typical High $954.99 | Professional | 54 · Surgery only | $741.31 | $933.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $186.21 Typical High $190.55 | Professional | 55 · Aftercare only | $147.91 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $123.03 Typical High $125.89 | Professional | 56 · Pre-op care only | $100.00 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $870.96 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $691.83 | $870.96 | $891.25 |
Where Missouri sits
The same service costs 5.9 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· 22nd of 51
$1,479
AK $4,365TX $741
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.