How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,479 to $10,715Professionalmedian $2,042 · 10th to 90th $1,445 to $5,012
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 $1,412.54 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,621.81 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $2,818.38 | Professional | None | $1,548.82 | $2,238.72 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,412.54 Typical High $1,778.28 | Professional | 62 · Two surgeons | $977.24 | $1,412.54 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $363.08 Typical High $446.68 | Professional | 80 · Assistant surgeon | $251.19 | $363.08 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $316.23 Typical High $389.05 | Professional | AS · PA/NP assist | $218.78 | $316.23 | $389.05 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,412.54 | $1,949.84 |
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 $1,412.54 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,621.81 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $26,302.68 | Facility | None | $1,513.56 | $4,466.84 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $3,630.78 Typical High $11,481.54 | Professional | None | $1,584.89 | $3,630.78 | $11,481.54 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,981.07 | Professional | None | $1,479.11 | $2,041.74 | $3,981.07 |
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 $707.95 Median $812.83 Typical High $870.96 | Professional | 52 · Reduced service | $707.95 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $323.59 Typical High $354.81 | Professional | 53 · Discontinued | $288.40 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $162.18 Typical High $177.83 | Professional | 56 · Pre-op care only | $141.25 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,230.27 |
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· 14th of 51
$2,344
AK $5,623UT $977
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.