How much rates vary
Facilitymedian $2,344 · 10th to 90th $631 to $7,244Professionalmedian $1,148 · 10th to 90th $813 to $2,138
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 $933.25 Typical High $1,548.82 | Professional | None | $724.44 | $933.25 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,479.11 | Professional | None | $870.96 | $1,122.02 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $707.95 Typical High $933.25 | Professional | 62 · Two surgeons | $549.54 | $707.95 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $181.97 Typical High $234.42 | Professional | 80 · Assistant surgeon | $138.04 | $181.97 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $158.49 Typical High $208.93 | Professional | AS · PA/NP assist | $120.23 | $158.49 | $208.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,122.02 | Professional | None | $724.44 | $812.83 | $1,122.02 |
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 $794.33 Median $912.01 Typical High $1,819.70 | Professional | None | $794.33 | $912.01 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $3,715.35 Typical High $16,218.10 | Facility | None | $1,023.29 | $3,715.35 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,819.70 Typical High $8,912.51 | Professional | None | $977.24 | $1,819.70 | $8,912.51 |
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 $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 $707.95 | Professional | 54 · Surgery only | $549.54 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $138.04 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $138.04 | $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 $645.65 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $512.86 | $645.65 | $660.69 |
Where Missouri sits
The same service costs 5.8 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
$1,288
AK $3,311UT $575
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.