How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,230 to $11,220Professionalmedian $1,023 · 10th to 90th $708 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 $794.33 Median $5,623.41 Typical High $8,709.64 | Facility | None | $794.33 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,698.24 | Professional | None | $575.44 | $724.44 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $1,000.00 | Professional | None | $446.68 | $758.58 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $9,549.93 | Facility | None | $1,412.54 | $3,801.89 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,479.11 | Professional | None | $776.25 | $1,148.15 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $707.95 Typical High $933.25 | Professional | 62 · Two surgeons | $489.78 | $707.95 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $181.97 Typical High $234.42 | Professional | 80 · Assistant surgeon | $123.03 | $181.97 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $162.18 Typical High $208.93 | Professional | AS · PA/NP assist | $107.15 | $162.18 | $208.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,023.29 | Professional | None | $660.69 | $741.31 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,548.13 Typical High $4,265.80 | Facility | None | $912.01 | $3,548.13 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,698.24 | Professional | None | $707.95 | $891.25 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $4,466.84 Typical High $26,302.68 | Facility | None | $1,023.29 | $4,466.84 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,862.09 Typical High $6,760.83 | Professional | None | $758.58 | $1,862.09 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $4,265.80 Typical High $8,709.64 | Facility | None | $1,513.56 | $4,265.80 | $8,709.64 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,949.84 | Professional | None | $758.58 | $1,023.29 | $1,949.84 |
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 $281.84 Median $354.81 Typical High $363.08 | Professional | 52 · Reduced service | $281.84 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $141.25 Typical High $147.91 | Professional | 53 · Discontinued | $114.82 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $524.81 Typical High $549.54 | Professional | 54 · Surgery only | $426.58 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $107.15 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $70.79 Typical High $72.44 | Professional | 56 · Pre-op care only | $57.54 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $489.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $398.11 | $489.78 | $512.86 |
Where Missouri sits
The same service costs 4.5 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $10,099MT $2,245
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.