How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,175 to $10,471Professionalmedian $1,230 · 10th to 90th $891 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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,548.82 | Professional | None | $794.33 | $1,023.29 | $1,548.82 |
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 $933.25 Median $1,230.27 Typical High $1,659.59 | Professional | None | $933.25 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $776.25 Typical High $1,047.13 | Professional | 62 · Two surgeons | $588.84 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $194.98 Typical High $263.03 | Professional | 80 · Assistant surgeon | $147.91 | $194.98 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $169.82 Typical High $234.42 | Professional | AS · PA/NP assist | $131.83 | $169.82 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,230.27 | Professional | None | $794.33 | $870.96 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $3,890.45 | Facility | None | $602.56 | $2,691.53 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,995.26 | Professional | None | $870.96 | $1,000.00 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $3,715.35 Typical High $16,218.10 | Facility | None | $1,071.52 | $3,715.35 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $6,456.54 | Professional | None | $1,071.52 | $1,995.26 | $6,456.54 |
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 $912.01 Median $1,348.96 Typical High $2,290.87 | Professional | None | $912.01 | $1,348.96 | $2,290.87 |
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 $398.11 Median $501.19 Typical High $512.86 | Professional | 52 · Reduced service | $398.11 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $199.53 Typical High $204.17 | Professional | 53 · Discontinued | $158.49 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $758.58 Typical High $776.25 | Professional | 54 · Surgery only | $602.56 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $151.36 Typical High $154.88 | Professional | 55 · Aftercare only | $120.23 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $100.00 Typical High $102.33 | Professional | 56 · Pre-op care only | $79.43 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $707.95 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $562.34 | $707.95 | $724.44 |
Where Missouri sits
The same service costs 5.6 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· 20th of 51
$1,445
AK $3,548UT $631
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.