How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,072 to $9,333Professionalmedian $724 · 10th to 90th $513 to $1,820
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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $1,174.90 | Professional | None | $512.86 | $575.44 | $1,174.90 |
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 $562.34 Median $851.14 Typical High $1,071.52 | Professional | None | $562.34 | $851.14 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,202.26 Typical High $1,584.89 | Professional | 50 · Both sides | $831.76 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $524.81 Typical High $676.08 | Professional | 62 · Two surgeons | $346.74 | $524.81 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $134.90 Typical High $169.82 | Professional | 80 · Assistant surgeon | $89.13 | $134.90 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $114.82 Typical High $147.91 | Professional | AS · PA/NP assist | $77.62 | $114.82 | $147.91 |
BCBS Kansas City Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $707.95 | Professional | None | $467.74 | $512.86 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,698.24 Typical High $2,511.89 | Facility | None | $446.68 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $1,148.15 | Professional | None | $501.19 | $575.44 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $2,754.23 Typical High $12,022.64 | Facility | None | $812.83 | $2,754.23 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,288.25 Typical High $7,585.78 | Professional | None | $562.34 | $1,288.25 | $7,585.78 |
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 $524.81 Median $724.44 Typical High $1,412.54 | Professional | None | $524.81 | $724.44 | $1,412.54 |
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 $251.19 Median $288.40 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $102.33 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $380.19 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $75.86 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $354.81 | $398.11 | $436.52 |
Where Missouri sits
The same service costs 5.5 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· 19th of 51
$871
AK $2,042UT $372
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.