How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,096 to $10,471Professionalmedian $871 · 10th to 90th $646 to $1,660
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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,445.44 | Professional | None | $575.44 | $741.31 | $1,445.44 |
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 $676.08 Median $870.96 Typical High $1,258.93 | Professional | None | $676.08 | $870.96 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $537.03 Typical High $794.33 | Professional | 62 · Two surgeons | $426.58 | $537.03 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $138.04 Typical High $199.53 | Professional | 80 · Assistant surgeon | $107.15 | $138.04 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $120.23 Typical High $173.78 | Professional | AS · PA/NP assist | $93.33 | $120.23 | $173.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $891.25 | Professional | None | $588.84 | $645.65 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,691.53 Typical High $3,890.45 | Facility | None | $645.65 | $2,691.53 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,445.44 | Professional | None | $630.96 | $724.44 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $2,754.23 Typical High $26,302.68 | Facility | None | $891.25 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,445.44 Typical High $5,370.32 | Professional | None | $776.25 | $1,445.44 | $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 $660.69 Median $954.99 Typical High $1,659.59 | Professional | None | $660.69 | $954.99 | $1,659.59 |
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 $288.40 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $288.40 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $144.54 | $147.91 |
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 $57.54 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $57.54 | $72.44 | $74.13 |
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 5.4 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· 26th of 51
$955
AK $2,570UT $479
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.