How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $9,772Professionalmedian $1,288 · 10th to 90th $1,023 to $2,818
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 $1,230.27 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,230.27 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,348.96 | Professional | None | $831.76 | $1,023.29 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,964.78 | Facility | None | $1,412.54 | $3,801.89 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,288.25 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $812.83 Typical High $1,230.27 | Professional | 62 · Two surgeons | $660.69 | $812.83 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $316.23 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $177.83 Typical High $275.42 | Professional | AS · PA/NP assist | $147.91 | $177.83 | $275.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,122.02 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,202.26 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $8,912.51 | Facility | None | $54.95 | $1,230.27 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,691.53 Typical High $8,128.31 | Professional | None | $1,122.02 | $2,691.53 | $8,128.31 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,445.44 | $2,818.38 |
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 $416.87 Median $512.86 Typical High $524.81 | Professional | 52 · Reduced service | $416.87 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $204.17 Typical High $213.80 | Professional | 53 · Discontinued | $165.96 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $776.25 Typical High $794.33 | Professional | 54 · Surgery only | $616.60 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $154.88 Typical High $158.49 | Professional | 55 · Aftercare only | $123.03 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $102.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $83.18 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $724.44 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $575.44 | $724.44 | $741.31 |
Where Missouri sits
The same service costs 7.1 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· 23rd of 51
$1,380
AK $4,365TX $617
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.