How much rates vary
Facilitymedian $2,818 · 10th to 90th $955 to $6,310Professionalmedian $1,000 · 10th to 90th $692 to $2,291
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 $645.65 Median $812.83 Typical High $2,511.89 | Professional | None | $645.65 | $812.83 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,348.96 | Professional | None | $724.44 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $630.96 Typical High $851.14 | Professional | 62 · Two surgeons | $457.09 | $630.96 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $162.18 Typical High $213.80 | Professional | 80 · Assistant surgeon | $114.82 | $162.18 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $141.25 Typical High $190.55 | Professional | AS · PA/NP assist | $102.33 | $141.25 | $190.55 |
BCBS Kansas City Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $977.24 | Professional | None | $630.96 | $691.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,691.53 Typical High $3,311.31 | Facility | None | $707.95 | $2,691.53 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,584.89 | Professional | None | $691.83 | $776.25 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,819.70 Typical High $5,248.07 | Facility | None | $54.95 | $1,819.70 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $1,548.82 Typical High $5,370.32 | Professional | None | $831.76 | $1,548.82 | $5,370.32 |
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 $724.44 Median $1,000.00 Typical High $1,862.09 | Professional | None | $724.44 | $1,000.00 | $1,862.09 |
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 $323.59 Median $398.11 Typical High $407.38 | Professional | 52 · Reduced service | $323.59 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $128.82 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $478.63 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $120.23 Typical High $123.03 | Professional | 55 · Aftercare only | $95.50 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $64.57 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $446.68 | $562.34 | $575.44 |
Where Missouri sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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
AK $8,442KY $1,804
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.