How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,175 to $17,378Professionalmedian $1,122 · 10th to 90th $794 to $2,754
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 $724.44 Median $912.01 Typical High $1,548.82 | Professional | None | $724.44 | $912.01 | $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 $851.14 Median $1,122.02 Typical High $1,584.89 | Professional | None | $851.14 | $1,122.02 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $707.95 Typical High $1,000.00 | Professional | 62 · Two surgeons | $537.03 | $707.95 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $173.78 Typical High $251.19 | Professional | 80 · Assistant surgeon | $138.04 | $173.78 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $154.88 Typical High $218.78 | Professional | AS · PA/NP assist | $120.23 | $154.88 | $218.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,122.02 | Professional | None | $724.44 | $794.33 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $17,378.01 Typical High $25,118.86 | Facility | None | $602.56 | $17,378.01 | $25,118.86 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,819.70 | Professional | None | $776.25 | $912.01 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $5,623.41 Typical High $95,499.26 | Facility | None | $1,122.02 | $5,623.41 | $95,499.26 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,778.28 Typical High $7,079.46 | Professional | None | $977.24 | $1,778.28 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $18,620.87 | Facility | None | $1,174.90 | $5,248.07 | $18,620.87 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $2,089.30 | Professional | None | $831.76 | $1,202.26 | $2,089.30 |
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 $363.08 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $363.08 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $181.97 Typical High $186.21 | Professional | 53 · Discontinued | $144.54 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $676.08 Typical High $691.83 | Professional | 54 · Surgery only | $549.54 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $134.90 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $91.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $72.44 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $630.96 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $512.86 | $630.96 | $645.65 |
Where Missouri sits
The same service costs 6.8 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· 26th of 51
$1,175
AK $3,715TX $550
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.