How much rates vary
Facilitymedian $3,020 · 10th to 90th $813 to $7,079Professionalmedian $851 · 10th to 90th $589 to $1,778
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 $676.08 Median $4,897.79 Typical High $7,762.47 | Facility | None | $676.08 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $741.31 | Professional | None | $478.63 | $588.84 | $741.31 |
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 $588.84 Median $891.25 Typical High $1,202.26 | Professional | None | $588.84 | $891.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $562.34 Typical High $758.58 | Professional | 62 · Two surgeons | $371.54 | $562.34 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $141.25 Typical High $190.55 | Professional | 80 · Assistant surgeon | $95.50 | $141.25 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $123.03 Typical High $165.96 | Professional | AS · PA/NP assist | $83.18 | $123.03 | $165.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $851.14 | Professional | None | $549.54 | $616.60 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,691.53 Typical High $3,311.31 | Facility | None | $707.95 | $2,691.53 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,412.54 | Professional | None | $588.84 | $691.83 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,187.76 Typical High $10,964.78 | Facility | None | $54.95 | $2,187.76 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,548.82 Typical High $4,570.88 | Professional | None | $645.65 | $1,548.82 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,621.81 | Professional | None | $616.60 | $851.14 | $1,621.81 |
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 $239.88 Median $295.12 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $446.68 Typical High $457.09 | Professional | 54 · Surgery only | $354.81 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $89.13 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $58.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $416.87 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $331.13 | $416.87 | $426.58 |
Where Missouri sits
The same service costs 6.2 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· 17th of 51
$1,023
AK $2,512UT $407
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.