How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $9,772Professionalmedian $1,023 · 10th to 90th $813 to $2,188
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 $912.01 Median $4,897.79 Typical High $7,762.47 | Facility | None | $912.01 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,023.29 | Professional | None | $645.65 | $794.33 | $1,023.29 |
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 $831.76 Median $1,023.29 Typical High $1,548.82 | Professional | None | $831.76 | $1,023.29 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $645.65 Typical High $954.99 | Professional | 62 · Two surgeons | $524.81 | $645.65 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $162.18 Typical High $245.47 | Professional | 80 · Assistant surgeon | $131.83 | $162.18 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $144.54 Typical High $213.80 | Professional | AS · PA/NP assist | $114.82 | $144.54 | $213.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,148.15 | Professional | None | $741.31 | $831.76 | $1,148.15 |
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 $794.33 Median $954.99 Typical High $1,905.46 | Professional | None | $794.33 | $954.99 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $6,918.31 | Facility | None | $54.95 | $1,230.27 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $2,137.96 Typical High $6,165.95 | Professional | None | $870.96 | $2,137.96 | $6,165.95 |
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 $851.14 Median $1,148.15 Typical High $2,187.76 | Professional | None | $851.14 | $1,148.15 | $2,187.76 |
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 $323.59 Median $398.11 Typical High $407.38 | Professional | 52 · Reduced service | $323.59 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $128.82 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $478.63 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $120.23 Typical High $123.03 | Professional | 55 · Aftercare only | $95.50 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $64.57 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $446.68 | $562.34 | $575.44 |
Where Missouri sits
The same service costs 6.3 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· 22nd of 51
$1,122
AK $3,388UT $537
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.